Immunoglobulin M 'Flare' after rituximab-associated acute tubular necrosis in Waldenström's macroglobulinemia.
Waldenström's macroglobulinemia (WM) is a low-grade lymphoplasmacytic lymphoma characterized by a circulating monoclonal IgM. Renal involvement in classical cases of WM is rare, and the pathological hallmark finding in the renal biopsy specimen is a thrombotic microangiopathy. We report the case of a 69-year-old man with the diagnosis of WM for 3 months before he presented with acute renal failure (ARF). A renal biopsy performed suggested the diagnosis of acute tubular necrosis. The diagnosis of ARF related to IgM flare after Rituximab therapy was made.
Izzedine
Hassane
H
Department of Nephrology, La Pitié-Salpêtrière Hospital, 47-80 Boulevard de l'Hôpital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie University, 75013, Paris, France. hassan.izzedine@psl.aphp.fr.
Bourry
Edward
E
Department of Nephrology, La Pitié-Salpêtrière Hospital, 47-80 Boulevard de l'Hôpital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie University, 75013, Paris, France.
Amrouche
Lucile
L
Department of Nephrology, La Pitié-Salpêtrière Hospital, 47-80 Boulevard de l'Hôpital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie University, 75013, Paris, France.
Brocheriou
Isabelle
I
Department of Pathology, Pitie-Salpetriere Hospital, Paris, France.
Uzunov
Madalina
M
Department of Clinical Hematology, Pitie-Salpetriere Hospital, Paris, France.
Capron
Frederique
F
Department of Pathology, Pitie-Salpetriere Hospital, Paris, France.
Leblond
Veronique
V
Department of Clinical Hematology, Pitie-Salpetriere Hospital, Paris, France.
Deray
Gilbert
G
Department of Nephrology, La Pitié-Salpêtrière Hospital, 47-80 Boulevard de l'Hôpital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie University, 75013, Paris, France.
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000473:pathology; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D058846:Antibodies, Monoclonal, Murine-Derived; D006801:Humans; D007075:Immunoglobulin M; D007684:Kidney Tubules / Q000187:drug effects / Q000473:pathology*; D008297:Male; D009336:Necrosis / Q000139:chemically induced; D000069283:Rituximab; D008258:Waldenstrom Macroglobulinemia / Q000150:complications* / Q000188:drug therapy / Q000473:pathology
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007075:Immunoglobulin M; D000069283:Rituximab