title: Lupus nephritis associated with CD20+ B-cell NHL.
abstract: The combination of NHL and documented malignancy-associated glomerulonephritis is uncommon. Also, no single renal pathological entity is consistently found in patients with NHL. Epstein-Barr virus (EBV) infection may manifest as systemic lupus erythematosus (SLE) and/or diffuse large cell lymphoma (DLBCL) in a genetically/ immunologically susceptible individual with defective cytotoxic T-cell response against EBV. We describe lupus nephritis in a 45 years old male suffering from untreated NHL. CD20+ DLBCL was demonstrated by immunohistochemistry of the neck lymph node (LN) biopsy performed for generalized lymphadenopathy. Renal biopsy revealed class V + IV lupus nephritis. Serology demonstrated EBV infection. Complete clinical remission of both SLE and DLBCL was achieved post-therapy with six-cycle rituximab, cyclophosphamide, vincristin, adriablastin, methylprednisolone (R-CHOP) regime. This case report demonstrated the complex relationships between NHL, SLE, EBV and membranous glomerulonephritis. The presented case is remarkable not only because of the rare association of SLE and DLBCL, but also because of its successful treatment with R-CHOP.
authors: Department of Nephrology and Clinical Transplantation, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre (IKDRC)- Dr H L Trivedi Institute of Transplantation Sciences (ITS), Civil Hospital Campus, Asarwa, Ahmedabad 380016, Gujarat, India.
authors: M R
authors: MR
authors: Gumber
authors: V B
authors: VB
authors: Kute
authors: K R
authors: KR
authors: Goplani
authors: P R
authors: PR
authors: Shah
authors: A V
authors: AV
authors: Vanikar
authors: H L
authors: HL
authors: Trivedi
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D004854:Herpesvirus 4, Human; D006801:Humans; D007150:Immunohistochemistry; D008181:Lupus Nephritis / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab