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继发于慢性淋巴细胞白血病的单克隆 IgG 沉积性增生性肾小球肾炎。两例报告。

Proliferative glomerulonephritis with monoclonal IgG deposits secondary to chronic lymphocytic leukemia. Report of two cases.

机构信息

Department of Nephrology, University of British Columbia, Vancouver, Canada.

出版信息

Nephrol Dial Transplant. 2011 Aug;26(8):2712-4. doi: 10.1093/ndt/gfr251. Epub 2011 Jun 1.

Abstract

Proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) is a recently described entity that is only rarely associated with a hematological or lymphoproliferative malignancy. We describe the cases of two men with preexisting chronic lymphocytic leukemia (CLL) who developed endocapillary proliferative glomerulonephritis with nonorganized monoclonal IgG(1) deposits. One biopsy also showed CLL infiltration of the cortex. Both patients were treated with rituximab in addition to cyclophosphamide in one case and fludarabine in the other with significant improvement of their renal disease and CLL. This report provides additional evidence to support the use of rituximab in the therapy of CLL-associated PGNMID.

摘要

伴单克隆 IgG 沉积的增生性肾小球肾炎(PGNMID)是一种最近才被描述的疾病实体,其与血液系统或淋巴增生性恶性肿瘤相关的情况非常罕见。我们描述了两例患有慢性淋巴细胞白血病(CLL)的男性患者,他们发展为伴有非典型性单克隆 IgG(1)沉积的毛细血管内增生性肾小球肾炎。其中一例肾活检还显示有 CLL 浸润皮质。两例患者均接受了利妥昔单抗联合环磷酰胺治疗(1 例)或氟达拉滨(另 1 例),其肾脏疾病和 CLL 均有显著改善。本报告提供了更多证据支持在 CLL 相关 PGNMID 的治疗中使用利妥昔单抗。

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