A Diverse Spectrum of Immune Complex– and Complement-Mediated Kidney Diseases Is Associated With Mantle Cell Lymphoma

Andeen, Nicole K.; Abdulameer, Shahad; Charu, Vivek; Zuckerman, Jonathan E.; Troxell, Megan L.; Kambham, Neeraja; Alpers, Charles E.; Najafian, Behzad; Nicosia, Roberto F.; Smith, Kelly D.; Kung, Vanderlene L.; Avasare, Rupali S.; Vallurupalli, Anusha; Jefferson, J. Ashley; Hecox, Douglas; Swetnam, Leah; Yamashita, M; Lin, Mercury; Bissonnette, Mei Lin Z.; Akilesh, Shreeram; Hou, Jean

doi:10.1016/j.ekir.2021.12.020

Cited by 5 publications

(4 citation statements)

References 54 publications

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“…A retrospective study collected all previous cases of MCL with abnormal renal function and found that all patients had improved or normalised renal function after lymphoma treatment [ 5 ]. In this instance, the patient received a BR regimen and saw a successful recovery of renal function following therapy.…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis and treatment of secondary nephrotic syndrome with rash as the first symptom: a case report

Qin,

Li,

Kuang

et al. 2024

BMC Nephrol

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Background Membranous nephropathy (MN) is a common type of nephrotic syndrome (NS) in adults, accounting for about 20–30% of cases. Although secondary to specific factors, the coexistence of MN and mantle cell lymphoma (MCL) has been scarcely reported in clinical literature. Case presentation A 59-year-old Chinese male was admitted to the hospital with a generalized pruritic rash with bilateral lower extremity edema, which did not improve significantly after symptomatic treatment. He had undergone renal biopsy, and the diagnosis was thought to be secondary MN (SMN), therefore, we did a lymph node biopsy on the patient and found that MN was complicated with MCL. Soon after, the patient was admitted to the hematology department for a BR chemotherapy regimen (composed of bendamustine 90 mg/m2 BSA (body surface area), rituximab 375 mg/m2 BSA and dexamethasone 5 mg), and during the post-treatment follow-up, both his symptoms and renal function improved. Conclusions The mechanism underlying the combination of SMN and MCL remains elusive and exceedingly rare, consequently often overlooked in clinical practice. This case serves to offer valuable clinical insights for diagnosis and treatment, while emphasizing the pivotal role of renal pathology in clinical assessment.

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Section: Discussionmentioning

confidence: 99%

“…SMN is usually caused by solid tumors, not by hematological malignancies, which are rare. In hematologic malignancies, renal injury associated with MCL usually also contains renal deposition of C3 or polyclonal immune deposits [ 5 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of secondary nephrotic syndrome with rash as the first symptom: a case report

Qin,

Li,

Kuang

et al. 2024

BMC Nephrol

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“…In another case, urine analysis showed IgG-lambda, but the kidney tissue showed IgG3-kappa type PGNMID, which differed significantly from the renal damage caused by plasma cells. [ 33 ] This highlights the importance of renal biopsy and considering lymphoma in the differential diagnosis when clonal inconsistency exists between the blood and kidney biopsy tissues.…”

Section: Discussionmentioning

confidence: 99%

Proliferative glomerulonephritis with monoclonal IgG Lambda deposits caused by plasmablastic lymphoma: a case report

Ren,

Chen,

Qiu

et al. 2023

BMC Nephrol

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Introduction As a very rare form of B-cell lymphoma, plasmablastic lymphoma (PBL) typically occurs in patients with underlying immunosuppression, including human immunodeficiency virus (HIV), organ transplantation, and autoimmune diseases. For HIV-positive patients, PBL normally originates in the gastrointestinal tract, especially from the oral cavity in most cases. It is extremely rare to find abdominal cavity involvement in PBL, and there has been no previously reported instance of proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) attributed to monoclonal IgG (MIgG) lambda secreted by PBL. Case presentation We report the case of an HIV-negative female with nephrotic syndrome, renal insufficiency, and multiple swollen lymph nodes. Ascitic fluid cytology revealed a high level of plasmablast-like lymphocytes with the restriction of lambda light chains. Besides, the renal biopsy revealed PGNMID, which could presumably be secondary to MIgG-lambda-secreting by PBL. MIgG-lambda-restricted expression was discovered earlier in the kidney tissue than in the blood. Conclusion The diagnostic landscape for PBL is notoriously intricate, necessitating a multifaceted and nuanced approach to mitigate the risks of erroneous identification.

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“…In another case, hematuria showed IgG-lambda, but the kidney tissue showed IgG3-kappa type PGNMID, which differed signi cantly from the renal damage caused by plasma cells. [23] This highlights the importance of renal biopsy and considering lymphoma in the differential diagnosis when clonal inconsistency exists between the blood and kidney.…”

Section: Discussionmentioning

confidence: 99%

Proliferative Glomerulonephritis with Monoclonal IgG Deposits Caused by Plasmablastic Lymphoma: A Case Report

renal,

Chen,

Qiu

et al. 2023

Preprint

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Introduction: As a very rare form of B-cell lymphoma, plasmablastic lymphoma (PBL) typically occurs in patients with underlying immunosuppression, including human immunodeficiency virus (HIV), organ transplantation, and autoimmune diseases. For HIV-positive patients, PBL normally originates in the gastrointestinal tract, especially from the oral cavity in most cases. It is extremely rare to find enterocoelial involvement in PBL, and there is no previous work reporting proliferative glomerulonephritis with monoclonal immunoglobulin deposits because of PBL that secretes lambda light chains. Case presentation: We report the case of a patient with nephrotic syndrome, renal insufficiency, and multiple swollen lymph nodes. Ascitic fluid cytology revealed high levels of PBL with the restriction of lambda light chains. Besides, a renal biopsy revealed proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID), which could presumably be secondary to lambda-light-chain-secreting PBL. Lambda light chain restriction in the kidney tissue was discovered earlier than in the blood. Conclusion The prognosis of patients with PBL is poor. Multimodal treatment with chemotherapy and newer targeted biological agents may be essential for the treatment of PBL. Unfortunately, the patient refused chemotherapy and died.

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A Diverse Spectrum of Immune Complex– and Complement-Mediated Kidney Diseases Is Associated With Mantle Cell Lymphoma

Cited by 5 publications

References 54 publications

Diagnosis and treatment of secondary nephrotic syndrome with rash as the first symptom: a case report

Diagnosis and treatment of secondary nephrotic syndrome with rash as the first symptom: a case report

Proliferative glomerulonephritis with monoclonal IgG Lambda deposits caused by plasmablastic lymphoma: a case report

Proliferative Glomerulonephritis with Monoclonal IgG Deposits Caused by Plasmablastic Lymphoma: A Case Report

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