title: Mini review: A unique case of crescentic C3 glomerulonephritis.
abstract: Kidney involvement is an under-recognized complication of non-Hodgkin lymphomas. They occur in a variety of mechanisms and differ widely in their clinical presentation. We take this opportunity to report a case of a 65 year-old man who developed a rapidly progressive glomerulonephritis within days after completing his first cycle of R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisolone) chemotherapy for newly diagnosed mantle cell lymphoma. He was odematous, hypertensive, oliguric with nephrotic range proteinuria and an active urine sediment. A renal biopsy showed a crescentic C3 glomerulonephritis (C3GN) with no evidence endocapillary or mesangial hypercellularity. He was promptly treated with immunosuppression and dialysis, with resumption of his chemotherapy. Genetic testing on complement proteins revealed a homozygous deletion spanning the CFHR1 and CFHR3 genes. Crescentic C3GN is a rare form of kidney injury, and this is the first known case of lymphoma-associated kidney involvement manifesting as C3GN. This article explores the possible mechanism of disease and reviews the literature of lymphoma-related kidney disease.
authors.affiliation: Brighton and Sussex University Hospital, Brighton, UK.
authors.forename: Dharmenaan
authors.initials: D
authors.lastname: Palamuthusingam
authors.affiliation: Department of Renal Medicine, Cairns Hospital, Cairns, Queensland, Australia.
authors.forename: Murty
authors.initials: M
authors.lastname: Mantha
authors.affiliation: Department of Anatomical Pathology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: Kimberley
authors.initials: K
authors.lastname: Oliver
authors.affiliation: Department of Haematology, Cairns Hospital, Cairns, Queensland, Australia.
authors.forename: Ketan
authors.initials: K
authors.lastname: Bavishi
authors.affiliation: Department of Renal Medicine, Cairns Hospital, Cairns, Queensland, Australia.
authors.forename: Shyam
authors.initials: S
authors.lastname: Dheda
mesh_terms: D000368:Aged; D015432:Glomerulonephritis, Membranoproliferative / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D008297:Male
keywords: acute kidney injury; glomerulonephritis; lymphoma