González Anglada M I, González García J, del Arco A, Picazo M L, Quevedo E, Vázquez Rodríguez J J
Departamento de Medicina Interna, Hospital La Paz, Madrid.
Med Clin (Barc). 1991 Oct 26;97(14):539-41.
Renal complications in Waldenström's macroglobulinemia (WM) are infrequent and are characterized by the presence of PAS positive amorphous hyaline deposits in the capillary lumen, infiltrated with lymphoplasmatic cells with PAS positive inclusions in the interstices and intratubular hyaline cylinders. Membranous glomerulonephritis may be a paraneoplastic manifestation of the lymphoproliferative processes. A 67-year-old male was diagnosed of WM, type-I cryoglobulinemia with renal insufficiency without proteinuria. Renal histological examination revealed changes characteristic of nephropathy associated to WM as well as membranous glomerulonephritis. This association has not been described previously. The coexistence of two pathogenic mechanisms with a common base, lymphoproliferative disease, may explain this association.
华氏巨球蛋白血症(WM)中的肾脏并发症并不常见,其特征为毛细血管腔内存在PAS阳性无定形透明沉积物,间质和肾小管内透明管型中有淋巴细胞浸润且伴有PAS阳性包涵体。膜性肾小球肾炎可能是淋巴增殖性疾病的副肿瘤表现。一名67岁男性被诊断为WM、I型冷球蛋白血症伴肾功能不全但无蛋白尿。肾脏组织学检查显示出与WM相关的肾病以及膜性肾小球肾炎的特征性改变。这种关联此前尚未见报道。两种具有共同基础即淋巴增殖性疾病的致病机制共存,可能解释了这种关联。