EBER-1 positive diffuse large cell lymphoma presenting as lupus nephritis.
Approximately one-third of membranous glomerulonephritis (MGN) cases in adults are associated with systemic diseases, including systemic lupus erythematosus (SLE) or malignancies. Malignancy-associated glomerulonephritis is rarely found in non-Hodgkin's lymphoma (NHL). Epstein-Barr virus (EBV) has been postulated to contribute to the pathogenesis of both SLE and NHL. We described a 37-year-old woman with nephrotic syndrome who presented with clinical features of SLE and renal-biopsy revealed lupus MGN. The patient also suffered from concomitant progressive lymphadenopathy and NHL (diffuse large B-cell type) was demonstrated by neck lymph node biopsy. Serologic studies demonstrated EBV infection and specific EBV antigens were present on lymph node and metastatic sites. We offer a discussion regarding the complex relationships between SLE, NHL, MGN and EBV.
Lin
Ming-Hsien
MH
Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, ROC.
Huang
Jeng-Jong
JJ
Chen
Tsai-Yun
TY
Chen
Fen-Fen
FF
Chang
Kong-Chao
KC
Liu
Ming-Fei
MF
Huang
Wen-Tsung
WT
Su
Wu-Chou
WC
Tsao
Chao-Jung
CJ
D058186:Acute Kidney Injury; D000328:Adult; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D018450:Disease Progression; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis*; D017809:Fatal Outcome; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000175:diagnosis / Q000473:pathology*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D007150:Immunohistochemistry; D008181:Lupus Nephritis / Q000175:diagnosis / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000473:pathology*; D012307:Risk Factors