IgA nephropathy in a patient with IgG lambda light-chain plasmacytoma: a rare coincidence

Forslund, Terje; Sikiö, Anu; Anttinen, Jorma

doi:10.1093/ndt/gfm351

Cited by 6 publications

(14 citation statements)

References 17 publications

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“…Paraneoplastic glomerulonephritis in haematological malignancies is rare and tends to manifest as minimal change disease, membranous glomerulonephritis or membranoproliferative glomerulonephritis [ 12 ]. IgAN has previously been associated with T cell lymphoma [ 11 , 13 , 14 ], Hodgkin lymphoma [ 9 , 15 , 16 ], B-cell lymphoma [ 10 , 17 ], leukaemia [ 10 , 18 ] and multiple myeloma [ 19 ] in various case reports (Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

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Paraneoplastic immunoglobulin A nephropathy and associated focal segmental glomerulosclerosis in asymptomatic low volume B-cell lymphoma – a case report

Francis

Pillai

et al. 2018

BMC Nephrol

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BackgroundParaneoplastic glomerulonephritis is rare in haematological malignancies and tends to manifest as minimal change disease, membranous glomerulonephritis or membranoproliferative glomerulonephritis. We present the first report of immunoglobulin A nephropathy and associated focal segmental glomerulosclerosis in a patient with asymptomatic low grade B-cell lymphoma.Case presentationA 53 year old gentleman presented with nephrotic range proteinuria (urine protein creatinine ratio of 662 mg/mmol) on a background of type 2 diabetes mellitus (glycosylated haemoglobin: < 6%), hypertension, obesity (body mass index: 47.6 kg/m2) and degenerative spine disease. Bone marrow biopsy diagnosed a low grade B-cell lymphoma and renal biopsy was consistent with immunoglobulin A nephropathy. Lymphoma treatment with six cycles of cyclophosphamide/ rituximab/ prednisolone led to normalisation of urinary protein excretion (urine protein creatinine ratio: 14 mg/mmol at 26 months post-chemotherapy).ConclusionParaneoplastic immunoglobulin A nephropathy can occur with a broad range of haematological malignancies regardless of stage. This case illustrates the importance of meticulous haematological system work-up for patients presenting with immunoglobulin A nephropathy. Recognition of paraneoplastic immunoglobulin A nephropathy and early diagnosis of associated malignancy can be life-saving.

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Section: Discussionmentioning

confidence: 99%

“…The timing of IgAN development and subsequent remission post chemotherapy suggests that IgAN is a paraneoplastic phenomenon in these cases [ 9 , 11 , 15 – 19 ]. Current models of IgAN pathogenesis involve the production of anomalous galactosylated-deficient IgA1 and antibodies against the under-galactosylated IgA1 [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Paraneoplastic immunoglobulin A nephropathy and associated focal segmental glomerulosclerosis in asymptomatic low volume B-cell lymphoma – a case report

Francis

Pillai

et al. 2018

BMC Nephrol

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“…Extended bortezomib therapy has been reported to be associated with the resolution of de novo IgA nephropathy in a patient with multiple myeloma [10]. Anti-CD20 monoclonal antibody therapy (rituximab) has been reported to induce remission in idiopathic MN [11].…”

Section: Discussionmentioning

confidence: 99%

Bortezomib therapy for nephrotic syndrome due to idiopathic membranous nephropathy

et al. 2014

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Idiopathic membranous nephropathy is a common cause of nephrotic syndrome in adults. The nephrotic syndrome due to idiopathic membranous nephropathy is often resistant to glucocorticosteroids and requires an alkylating agent such as chlorambucil or cyclophosphamide to induce remission. Recent studies illustrate that antibodies against the autoantigen M-type phospholipase A2 receptor contribute to a vast majority but not all cases of idiopathic membranous nephropathy. Herein, we report a patient with nephrotic syndrome due to membranous nephropathy that was resistant to 6 months of therapy with ramipril and high-dose glucocorticosteroids but responded to a single cycle of bortezomib infusion.

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“…Very little is known about the relationship between IgA nephropathy and IgG myeloma; for there were only two similar reports[ 9 10 ] published [ Table 1 ]. [ 3 7 9 10 11 12 ]…”

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confidence: 99%

“…The first patient[ 9 ] was a 76-year-old man who had right-sided loin pain and back pain. Magnetic resonance imaging showed a tumor mass compressing the lower part of the thoracic spinal cord.…”

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confidence: 99%

IgA nephropathy in a patient with IgG myeloma

Lakshmi¹,

Devi²,

Sameera³

et al. 2018

Indian J Nephrol

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IgA nephropathy in a patient with IgG lambda light-chain plasmacytoma: a rare coincidence

Cited by 6 publications

References 17 publications

Paraneoplastic immunoglobulin A nephropathy and associated focal segmental glomerulosclerosis in asymptomatic low volume B-cell lymphoma – a case report

Paraneoplastic immunoglobulin A nephropathy and associated focal segmental glomerulosclerosis in asymptomatic low volume B-cell lymphoma – a case report

Bortezomib therapy for nephrotic syndrome due to idiopathic membranous nephropathy

IgA nephropathy in a patient with IgG myeloma

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