title: Waldenstrom macroglobulinemia with CD5+ expression presented as cryoglobulinemic glomerulonephropathy: a case report.
abstract: Waldenstrom macroglobulinemia (WM) is a B-cell lymphoproliferative disorder associated with bone marrow involvement of lymphoplasmacytic lymphoma (LPL) and an IgM monoclonal gammopathy. Generally B-lymphocytes in LPL do not express CD5 that is important for differential diagnosis of B-cell lymphoproliferative disorders. In WM, various renal diseases and type I cryoglobulinemia are well described separately, but cryoglobulinemic glomerulonephropathy is very rarely reported. A 61-yr-old woman complained of generalized edema, cyanosis of the extremities in cold weather, visual disturbance, and pancytopenia. Bone marrow and renal biopsy showed CD5+ expressing B-cells and cryoglobulinemic glomerulonephropathy. With the diagnosis of WM, she received cyclophosphamide, doxorubicin, vincristine and prednisolone chemotherapy and got complete remission. Here, we report a rare case of WM associated with unusual expression of CD5+ B-lymphocytes and cryoglobulinemic glomerulonephropathy, and emphasize the importance of the clinical features in differentiating CD5+ B-cell lymphoproliferative disorders.
authors.affiliation: Department of Internal Medicine, Eulji University College of Medicine, Seoul, Korea.
authors.forename: You Lim
authors.initials: YL
authors.lastname: Kim
authors.forename: Soo Jung
authors.initials: SJ
authors.lastname: Gong
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Hwang
authors.forename: Jong Eun
authors.initials: JE
authors.lastname: Joo
authors.forename: Young Uk
authors.initials: YU
authors.lastname: Cho
authors.forename: Jung Ae
authors.initials: JA
authors.lastname: Lee
authors.forename: Su Ah
authors.initials: SA
authors.lastname: Sung
authors.forename: So Young
authors.initials: SY
authors.lastname: Lee
authors.forename: Nae Yoo
authors.initials: NY
authors.lastname: Kim
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000276:immunology / Q000378:metabolism; D001853:Bone Marrow / Q000473:pathology; D018956:CD5 Antigens / Q000378:metabolism*; D003449:Cryoglobulinemia / Q000175:diagnosis; D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology; D008875:Middle Aged; D010265:Paraproteinemias / Q000175:diagnosis; D011239:Prednisolone / Q000627:therapeutic use; D014750:Vincristine / Q000627:therapeutic use; D008258:Waldenstrom Macroglobulinemia / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents; D018956:CD5 Antigens; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone