Recovery of kidney function by rituximab-based therapy in a patient with Waldenström's macroglobulinemia-related nephropathy presenting cast nephropathy and interstitial lymphocytic infiltration.
A 60-year-old man with Waldenström's macroglobulinemia (WM) was admitted to our hospital for evaluation of rapid progressive renal deterioration despite 3 cycles of oral melphalan and prednisolone (MP) therapy. Renal biopsy just before introducing hemodialysis revealed cast nephropathy and severe tubulo-interstitial infiltration of B lymphocytes. After 6 cycles of rituximab, cyclophosphamide, vincristine and prednisolone (R-COP) therapy, his renal function improved enough to discontinue hemodialysis. This is a rare case of WM-related renal involvement caused by both monoclonal protein and tumor infiltration and, to our knowledge, the second report on improved renal function by rituximab-based therapy.
Internal Medicine I, Division of Nephrology, Hamamatsu University School of Medicine, Japan.
Masashi
M
Miwa
Yukitoshi
Y
Sakao
Sayaka
S
Ishigaki
Masafumi
M
Ono
Tomoyuki
T
Fujikura
Hideo
H
Yasuda
Hiroyuki
H
Suzuki
Akihiko
A
Kato
Yasuyuki
Y
Nagata
Kazuyuki
K
Shigeno
Satoki
S
Nakamura
Kazunori
K
Ohnishi
Yoshihide
Y
Fujigaki
D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols; D003404:Creatinine / Q000097:blood; D003520:Cyclophosphamide / Q000008:administration & dosage; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D006435:Renal Dialysis; D000069283:Rituximab; D014750:Vincristine / Q000008:administration & dosage; D008258:Waldenstrom Macroglobulinemia / Q000150:complications* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*
D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D003520:Cyclophosphamide; D011239:Prednisolone; D003404:Creatinine