A male with angioimmunoblastic T-cell lymphoma and proliferative glomerulonephritis.
In this article we present the case report of a 67-year-old male with a nephrotic syndrome due to a proliferative glomerulonephritis, associated with an angioimmunoblastic T-cell lymphoma. Diagnosis was made on an axillary lymph node biopsy and showed expanded T-cell areas with multiple blood vessels, small mature lymphocytes, eosinophils, and plasma cells. A kidney biopsy was suggestive for a proliferative glomerulonephritis with intra- and extracapillary proliferation. Hypercellular glomeruli were seen, as well as multiple floride crescents. Interstitial edema and fibrosis were absent. Immunohistochemical reactions were negative; there was some mesangial reaction with IgM in the glomeruli. Treatment with high-dose corticosteroids was initiated, with clinical improvement, and was immediately followed by therapy with cyclophosphamide, hydroxydaunomycin, vincristine, and prednisone (CHOP), which induced complete remission with a follow-up of 1 year. To our knowledge, the association of angioimmunoblastic T-cell lymphoma and proliferative glomerulonephritis has only been described twice. It concerned elderly men who developed acute renal failure a couple of months after the diagnosis of an angioimmunoblastic T-cell lymphoma. In both, immunoglobulin-containing dense deposits within glomeruli were observed, which was not the case in our patient, where only some mesangial colorization of the IgM in the glomeruli was seen.
De Samblanx
Hadewijch
H
Hematology Unit, University Hospital Leuven, Leuven, Belgium.
Verhoef
Gregor
G
Zachée
Pierre
P
Vandenberghe
Peter
P
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001323:Autoantibodies / Q000032:analysis; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004317:Doxorubicin / Q000008:administration & dosage; D015432:Glomerulonephritis, Membranoproliferative / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D007075:Immunoglobulin M / Q000032:analysis; D007668:Kidney / Q000473:pathology; D007684:Kidney Tubules / Q000276:immunology; D016399:Lymphoma, T-Cell / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D009404:Nephrotic Syndrome / Q000209:etiology; D011241:Prednisone / Q000008:administration & dosage; D012074:Remission Induction; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000209:etiology; D014750:Vincristine / Q000008:administration & dosage
D000305:Adrenal Cortex Hormones; D001323:Autoantibodies; D007075:Immunoglobulin M; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone