A case of Castleman's disease complicated with nephrotic syndrome due to glomerulopathy mimicking membranoproliferative glomerulonephritis.
Castleman's disease is a rare atypical lymphoproliferative disorder. Renal manifestations, such as proteinuria, hematuria, and renal dysfunction, are common in Castleman's disease; however, a nephrotic syndrome rarely occurs. We have encountered an unusual case of Castleman's disease of the plasma cell type characterized by nephrotic syndrome because of glomerulopathy mimicking membranoproliferative glomerulonephritis. Our patient showed higher levels of circulating cytokines (interleukin-6/vascular endothelial cell-derived growth factor), the glomerular lesions not associated with immunocomplex deposition, and the resolution of nephrotic syndrome after successful corticosteroids therapy resulting in a decline in cytokines levels, thereby implicating a cytokine-induced glomerular cell injury/activation as a possible cause of the glomerular pathological changes in this case.
Department of Medicine, Shiga University of Medical Science, Seta, Otsu, Shiga 5202192, Japan. toshiro@belle.shiga-med.ac.jp
Toshiro
T
Sugimoto
Jun
J
Ito
Naoko
N
Takeda
Ippei
I
Gasyu
Tsutomu
T
Okazaki
Masayoshi
M
Sakaguchi
Norihisa
N
Osawa
Yuki
Y
Tanaka
Kazumasa
K
Oka
Takashi
T
Uzu
Atsunori
A
Kashiwagi
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D005871:Castleman Disease / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005921:Glomerulonephritis / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D015432:Glomerulonephritis, Membranoproliferative / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007678:Kidney Glomerulus / Q000648:ultrastructure*; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D011239:Prednisolone