Nephrotic syndrome caused by protein thrombi in glomerulocapillary lumen in Waldenström's macroglobulinaemia.
Waldenström's macroglobulinaemia (WM) is described as a disorder of plasmacytoid lymphocytes. The renal complications of WM are less common and severe than those of multiple myeloma. We present a case of WM complicated by nephrotic syndrome. A biopsy specimen of the kidney revealed the intraglomerular thrombi of immunoglobulin M paraprotein. Corticosteroid pulse therapy and plasmapheresis were effective in improving proteinuria and reducing protein thrombi. The nephrotic syndrome caused by protein thrombi in WM may be reversible, at least in its early stage.
Harada
Y
Y
The Third Department of Internal Medicine, Tokyo Medical University Hospital, Tokyo, Japan. yharada@tokyo-med.ac.jp
Ido
N
N
Okada
T
T
Otani
M
M
Shirota
T
T
Nakao
T
T
Hayashi
T
T
D000368:Aged; D005455:Fluorescent Antibody Technique; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D007678:Kidney Glomerulus / Q000473:pathology; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy; D010266:Paraproteins / Q000032:analysis; D010956:Plasmapheresis; D013927:Thrombosis / Q000150:complications / Q000473:pathology; D008258:Waldenstrom Macroglobulinemia / Q000150:complications* / Q000188:drug therapy / Q000628:therapy
D005938:Glucocorticoids; D007075:Immunoglobulin M; D010266:Paraproteins; D008775:Methylprednisolone