title: The spectrum of kidney pathology in B-cell chronic lymphocytic leukemia / small lymphocytic lymphoma: a 25-year multicenter experience.
abstract: BACKGROUND
  Chronic lymphocytic leukemia and small lymphocytic lymphoma are 2 different presentations of the most common B-cell neoplasm in western countries (CLL/SLL). In this disease, kidney involvement is usually silent, and is rarely reported in the literature. This study provides a clinicopathological analysis of all-cause kidney disease in CLL/SLL patients.
  
  
  METHODS
  Fifteen CLL/SLL patients with kidney biopsy were identified retrospectively. Demographic, clinical, pathological and laboratory data were assessed at biopsy, and during follow-up.
  
  
  RESULTS
  At biopsy 11 patients presented impaired renal function, 7 patients nephrotic syndrome, 6 patients dysproteinemia, and 3 patients cryoglobulinemia. Kidney pathology revealed CLL/SLL-specific monoclonal infiltrate in 10 biopsies, glomerulopathy in 9 biopsies (5 membranoproliferative glomerulonephritis, 2 minimal change disease, 1 glomerulonephritis with organized microtubular monoclonal immunoglobulin deposits, 1 AHL amyloidosis). Five patients presented interstitial granulomas attributed to CLL/SLL. After treatment of the hematological disease, improvement of renal function was observed in 7/11 patients, and remission of nephrotic syndrome in 5/7 patients. During follow-up, aggravation of the kidney disease systematically occurred in the absence of favorable response to hematological treatment.
  
  
  CONCLUSIONS
  A broad spectrum of kidney diseases is associated with CLL/SLL. In this setting, kidney biopsy can provide important information for diagnosis and therapeutic guidance.
authors: Service de Néphrologie, CHU Hôpitaux de Rouen, Rouen, France.
authors: Anne-Laure
authors: AL
authors: Poitou-Verkinder
authors: Service d'Anatomie Pathologique, CHU Hôpitaux de Rouen, Rouen, France.
authors: Arnaud
authors: A
authors: Francois
authors: Service d'Anatomie Pathologique, CHU Hôpitaux de Rouen, Rouen, France.
authors: Fanny
authors: F
authors: Drieux
authors: Service d'Hématologie, Centre Henri Becquerel, Rouen, France.
authors: Stéphane
authors: S
authors: Lepretre
authors: Service de Néphrologie, CHU Hôpitaux de Rouen, Rouen, France.
authors: Bruno
authors: B
authors: Legallicier
authors: Service de Néphrologie, CHU Hôpitaux de Strasbourg, Strasbourg, France.
authors: Bruno
authors: B
authors: Moulin
authors: Service de Néphrologie, CHU Hôpitaux de Rouen, Rouen, France; INSERM Unité 1096, Université de Médecine-Pharmacie de Rouen, Rouen, France.
authors: Michel
authors: M
authors: Godin
authors: Service de Néphrologie, CHU Hôpitaux de Rouen, Rouen, France; INSERM Unité 1096, Université de Médecine-Pharmacie de Rouen, Rouen, France.
authors: Dominique
authors: D
authors: Guerrot
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D005921:Glomerulonephritis / Q000150:complications; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000150:complications; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies