华氏巨球蛋白血症中利妥昔单抗相关急性肾小管坏死后的免疫球蛋白M“flare”

Immunoglobulin M 'Flare' after rituximab-associated acute tubular necrosis in Waldenström's macroglobulinemia.

作者信息

Izzedine Hassane, Bourry Edward, Amrouche Lucile, Brocheriou Isabelle, Uzunov Madalina, Capron Frederique, Leblond Veronique, Deray Gilbert

机构信息

Department of Nephrology, La Pitié-Salpêtrière Hospital, 47-80 Boulevard de l'Hôpital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie University, 75013, Paris, France.

Department of Pathology, Pitie-Salpetriere Hospital, Paris, France.

出版信息

Int J Hematol. 2009 Mar;89(2):218-222. doi: 10.1007/s12185-008-0244-7. Epub 2009 Jan 21.

DOI:10.1007/s12185-008-0244-7

PMID:19156501

Abstract

Waldenström's macroglobulinemia (WM) is a low-grade lymphoplasmacytic lymphoma characterized by a circulating monoclonal IgM. Renal involvement in classical cases of WM is rare, and the pathological hallmark finding in the renal biopsy specimen is a thrombotic microangiopathy. We report the case of a 69-year-old man with the diagnosis of WM for 3 months before he presented with acute renal failure (ARF). A renal biopsy performed suggested the diagnosis of acute tubular necrosis. The diagnosis of ARF related to IgM flare after Rituximab therapy was made.

摘要

华氏巨球蛋白血症（WM）是一种以循环单克隆IgM为特征的低度淋巴浆细胞淋巴瘤。在经典的WM病例中，肾脏受累情况罕见，肾活检标本中的病理标志性发现是血栓性微血管病。我们报告了一例69岁男性病例，该患者在诊断为WM 3个月后出现急性肾衰竭（ARF）。肾脏活检提示急性肾小管坏死的诊断。最终诊断为利妥昔单抗治疗后与IgM激增相关的ARF。