title: A male with angioimmunoblastic T-cell lymphoma and proliferative glomerulonephritis.
abstract: 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.
authors.affiliation: Hematology Unit, University Hospital Leuven, Leuven, Belgium.
authors.forename: Hadewijch
authors.initials: H
authors.lastname: De Samblanx
authors.forename: Gregor
authors.initials: G
authors.lastname: Verhoef
authors.forename: Pierre
authors.initials: P
authors.lastname: Zachée
authors.forename: Peter
authors.initials: P
authors.lastname: Vandenberghe
mesh_terms: 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
chemical_list: D000305:Adrenal Cortex Hormones; D001323:Autoantibodies; D007075:Immunoglobulin M; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone