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华氏巨球蛋白血症患者因免疫复合物介导的肾损伤导致肾病综合征和肾衰竭:一例报告

Nephrotic syndrome and kidney failure due to immunocomplex-mediated renal damage in a patient with Waldenström's Macroglobulinemia: a case report.

作者信息

Castro Hector, Valenzuela Rafael, Ruiz Phillip, Lenz Oliver, Monrroy Mauricio

机构信息

Department of Medicine, Division of General Internal Medicine, University of Miami/Jackson Memorial Medical Center, Miami, Florida, USA.

出版信息

Cases J. 2008 Nov 19;1(1):333. doi: 10.1186/1757-1626-1-333.

Abstract

INTRODUCTION

Unlike the quite frequent renal involvement seen in cases of Multiple Myeloma, the kidney is hardly ever compromised in patients with Waldenström's Macroglobulinemia. Nephrotic range proteinuria is a very unusual manifestation of renal injury in these patients and when present it is due to amyloid light-chain deposition most of the times.

CASE PRESENTATION

A 60-year-old male patient presented to the hospital with nephrotic syndrome, renal insufficiency, hypertension and lymphadenopathy. The investigations led to the diagnosis of Waldenström's Macroglobulinemia with associated nephrotic syndrome and chronic kidney disease due to an unusual form of hypocomplementemic glomerulopathy with histopathological features similar to those seen in mesangiocapillary glomerulonephritis type III, but lacking proliferative changes.

CONCLUSION

We present an unusual case of immunologically-mediated renal damage in a patient with Waldenström's Macroglobulinemia, leading to non-amyloid nephrotic syndrome and chronic renal insufficiency.

摘要

引言

与多发性骨髓瘤病例中较为常见的肾脏受累情况不同,华氏巨球蛋白血症患者的肾脏很少受到损害。肾病范围蛋白尿是这些患者肾损伤的一种非常不寻常的表现,出现时大多是由于淀粉样轻链沉积。

病例报告

一名60岁男性患者因肾病综合征、肾功能不全、高血压和淋巴结病入院。检查诊断为华氏巨球蛋白血症合并肾病综合征和慢性肾脏病,病因是一种不寻常的低补体血症性肾小球病,其组织病理学特征与III型系膜毛细血管性肾小球肾炎相似,但缺乏增殖性改变。

结论

我们报告了一例华氏巨球蛋白血症患者免疫介导性肾损伤的不寻常病例,导致非淀粉样肾病综合征和慢性肾功能不全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a62a/2600791/1b8a211807b8/1757-1626-1-333-1.jpg

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