[Persistent polyclonal B-cell lymphocytosis].
METHODS
A 54-year-old woman was referred for ambulant checkup after an episode of acute renal failure due to severe gastroenteritis and recurrent arthralgias. Physical examination was unremarkable except for the presence of palpable small cervical lymph nodes.


METHODS
Serum IgM levels showed a polyclonal increase. All the other routinely examined parameters were within normal limits. Microscopical blood smear examination revealed binucleated lymphocytes. Immunophenotyping of peripheral blood showed a polyclonal B-cell lymphocytosis despite normal numbers of leukocytes and lymphocytes. PCR analysis identified cells with a t(14;18) translocation (bcl-2/IgH rearrangement).


METHODS
A routine medical checkup disclosed the diagnosis of persistent polyclonal B-cell lymphocytosis. This rare benign lymphoproliferative disorder is characterized by binucleated lymphocytes, polyclonal expansion of B-cells, and a polyclonal increase in serum IgM. The diagnosis was established despite the lack of leukocytosis or lymphocytosis in the peripheral blood.


CONCLUSIONS
Because of its benign and indolent course without the need for chemotherapy, it is important to discriminate the disorder of persistent polyclonal B-cell lymphocytosis from other malignant lymphoproliferative diseases.
Schwerpunkt Nephrologie, Medizinische Klinik und Poliklinik I, Klinikum der udwig-Maximilians-Universität München, Munich.
U
U
Schönermarck
H
H
Diem
P
P
Lohse
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W
Samtleben
D058186:Acute Kidney Injury / Q000209:etiology; D018771:Arthralgia / Q000150:complications; D001402:B-Lymphocytes / Q000145:classification / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D005759:Gastroenteritis / Q000150:complications; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D016130:Immunophenotyping; D008198:Lymph Nodes / Q000473:pathology; D008218:Lymphocytosis / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D016133:Polymerase Chain Reaction
D007075:Immunoglobulin M