title: Minimal change nephrotic syndrome associated with non-Hodgkin lymphoid disorders: a retrospective study of 18 cases.
abstract: Few studies have examined the occurrence of minimal change nephrotic syndrome (MCNS) in patients with non-Hodgkin lymphoma (NHL). We report here a series of 18 patients with MCNS occurring among 13,992 new cases of NHL. We analyzed the clinical and pathologic characteristics of this association, along with the response of patients to treatment, to determine if this association relies on a particular disorder. The most frequent NHLs associated with MCNS were Waldenström macroglobulinemia (33.3%), marginal zone B-cell lymphoma (27.8%), and chronic lymphocytic leukemia (22.2%). Other lymphoproliferative disorders included multiple myeloma, mantle cell lymphoma, and peripheral T-cell lymphoma. In 4 patients MCNS occurred before NHL (mean delay, 15 mo), in 10 patients the disorders occurred simultaneously, and in 4 patients MCNS was diagnosed after NHL (mean delay, 25 mo). Circulating monoclonal immunoglobulins were present in 11 patients. A nontumoral interstitial infiltrate was present in renal biopsy specimens from 3 patients without significant renal impairment. Acute kidney injury resulting from tubular lesions or renal hypoperfusion was present in 6 patients. MCNS relapse occurred more frequently in patients treated exclusively by steroid therapy (77.8%) than in those receiving steroids associated with chemotherapy (25%). In conclusion, MCNS occurs preferentially in NHL originating from B cells and requires an aggressive therapeutic approach to reduce the risk of MCNS relapse.
authors.affiliation: Service de Néphrologie et Transplantation, Groupe hospitalier Henri-Mondor/Albert-Chenevier, Centre de référence maladie rare Syndrome Néphrotique Idiopathique, Institut Francilien de recherche en Néphrologie et Transplantation (IFRNT), AP-HP (Assistance Publique-Hôpitaux de Paris, Créteil), Université Paris Est Créteil, Créteil (TK, DD, PG, PL, DS, VA); Equipe 21, INSERM Unité 955, Université Paris Est Créteil, Créteil (TK, SYZ, AM, DD, PG, PL, DS, VA); Département de Pathologie, Groupe hospitalier Henri-Mondor/Albert-Chenevier, AP-HP, Université Paris Est Créteil, Créteil (CCB, AM); Equipe 9, INSERM Unité 955, Université Paris Est Créteil, Créteil (CCB, CH); Service de Néphrologie, Hôpital Bichat, AP-HP, Université Paris Diderot, Paris (QR); Service de Néphrologie, Hôpital Kremlin Bicêtre, IFRNT, AP-HP, INSERM Unité 1014, Université Paris Sud, Kremlin Bicêtre (HF); Service de Néphrologie, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Descartes, Paris (AK); Service de Néphrologie et Dialyse, Hôpital Tenon, AP-HP, INSERM Unité 702, Université Pierre et Marie Curie-Paris 6, Paris (EP); Service de Néphrologie et Hémodialyse, Centre Hospitalier de Cambrai (BP); Service de Néphrologie, Hopital Pasteur, Université Nice Sophia Antipolis, Nice (GF); Service de Néphrologie et Transplantation, Hôpital Charles Nicolle, Université de Rouen, Rouen (DB); Service d'Hématologie et Thérapie cellulaire, Hôpital Bretonneau, Centre Hospitalier Universitaire de Tours, Université de Tours François Rabelais, Tours (EG); Service de Néphrologie, Centre Hospitalier intercommunal de Poissy Saint Germain en Laye (MS); Service d'Hématologie clinique, Hôpital La Pitié Salpêtrière, AP-HP, Université Pierre et Marie Curie Paris 06, GRC 11 (GRECHY), Paris (DRW); and Unité d'Hémopathies Lymphoïdes, AP-HP, Groupe hospitalier Henri-Mondor/Albert-Chenevier, Université Paris Est Créteil, Créteil (CH), France.
authors.forename: Tomek
authors.initials: T
authors.lastname: Kofman
authors.forename: Shao-Yu
authors.initials: SY
authors.lastname: Zhang
authors.forename: Christiane
authors.initials: C
authors.lastname: Copie-Bergman
authors.forename: Anissa
authors.initials: A
authors.lastname: Moktefi
authors.forename: Quentin
authors.initials: Q
authors.lastname: Raimbourg
authors.forename: Hélène
authors.initials: H
authors.lastname: Francois
authors.forename: Alexandre
authors.initials: A
authors.lastname: Karras
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Plaisier
authors.forename: Bernard
authors.initials: B
authors.lastname: Painchart
authors.forename: Guillaume
authors.initials: G
authors.lastname: Favre
authors.forename: Dominique
authors.initials: D
authors.lastname: Bertrand
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Gyan
authors.forename: Marc
authors.initials: M
authors.lastname: Souid
authors.forename: Damien
authors.initials: D
authors.lastname: Roos-Weil
authors.forename: Dominique
authors.initials: D
authors.lastname: Desvaux
authors.forename: Philippe
authors.initials: P
authors.lastname: Grimbert
authors.forename: Corinne
authors.initials: C
authors.lastname: Haioun
authors.forename: Philippe
authors.initials: P
authors.lastname: Lang
authors.forename: Djillali
authors.initials: D
authors.lastname: Sahali
authors.forename: Vincent
authors.initials: V
authors.lastname: Audard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications; D016393:Lymphoma, B-Cell / Q000150:complications; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D013997:Time Factors; D008258:Waldenstrom Macroglobulinemia / Q000150:complications