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Renal involvement in Waldenström's macroglobulinemia: case report and review of literature.
[waldenström macroglobulinemia]
Waldenström
's
macroglobulinemia
(
WM
)
is
a
rare
lymphoid
neoplasia
,
accounting
for
2
%
of
all
hematological
malignancies
.
Renal
complications
occur
rather
rarely
compared
to
multiple
myeloma
.
The
most
common
renal
manifestations
are
mild
proteinuria
and
microhematuria
.
We
describe
a
case
of
MW
presenting
with
acute
renal
failure
and
NS
.
A
67
-
year
-old
man
was
referred
to
our
hospital
for
sudden
onset
nephrotic
syndrome
.
Electrophoresis
revealed
a
monoclonal
component
in
the
gamma
region
,
which
was
classified
as
an
IgM
k
.
During
hospitalization
,
acute
kidney
injury
developed
,
with
creatinine
up
to
5
 
mg
/
dL
,
despite
adequate
hydration
and
alkalinization
.
A
kidney
biopsy
was
performed
,
showing
minimal
change
disease
(
MCD
)
with
interstitial
and
capsular
lymphoid
infiltrates
of
B-Lymphocytes
CD
2
0
+
.
B-
lymphocytes
infiltration
suggested
the
possibility
of
renal
localization
of
lymphoproliferative
disorder
.
So
,
bone
marrow
histology
was
performed
,
revealing
lymphoplasmacytic
lymphoma
(
WM
)
.
The
patient
was
treated
with
bortezomib
,
desamethasone
,
and
rituximab
,
with
partial
recovery
of
renal
function
(
creatinine
1
.
5
 
mg
/
dL
)
and
complete
remission
of
proteinuria
after
8
-
month
follow-up
.
The
remission
of
NS
in
our
patient
with
rituximab
seems
to
emphasize
the
pathogenetic
role
of
B
cells
in
MCD
,
although
a
coincident
effect
of
immunosuppression
on
both
the
underlying
renal
disease
and
the
hematologic
disease
can
not
be
excluded
.
Diseases
Validation
Diseases presenting
"neoplasia"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
aniridia
carcinoma of the gallbladder
cholangiocarcinoma
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dentin dysplasia
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
hodgkin lymphoma, classical
liposarcoma
lymphangioleiomyomatosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
pleomorphic liposarcoma
primary effusion lymphoma
pyomyositis
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wolf-hirschhorn syndrome
This symptom has already been validated