Minakawa Akihiro, Hisanaga Shuichi, Sato Yuji, Fujimoto Shouichi
Department of Internal Medicine, Division of Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, Miyazaki-City, Miyazaki, Japan.
Department of Internal Medicine, Koga General Hospital, Miyazaki-City, Miyazaki, Japan.
BMJ Case Rep. 2016 Feb 23;2016:bcr2016214366. doi: 10.1136/bcr-2016-214366.
A 63-year-old man was referred to our hospital because of renal dysfunction with haematoproteinuria. Intraperitoneal lymph node enlargement was also noted. M protein was not detected by electrophoresis of his serum and urine; however, an increase in the κ/λ ratio was detected by free light-chain assay. Percutaneous kidney biopsy was performed, and the patient was diagnosed with proliferative glomerulonephritis with monoclonal immunoglobulin deposits. Lymph node biopsy showed follicular lymphoma. Urinalysis findings improved after treatment of the lymphoma. Proliferative glomerulonephritis with monoclonal immunoglobulin deposits is rarely considered to be associated with haematological disease. We report a case of lymphoma-associated proliferative glomerulonephritis with monoclonal immunoglobulin deposits with light-chain abnormality detected by free light-chain assay, but not by electrophoresis.
一名63岁男性因肾功能不全伴血红蛋白尿被转诊至我院。还发现腹膜后淋巴结肿大。血清和尿液电泳未检测到M蛋白；然而，通过游离轻链检测发现κ/λ比值升高。进行了经皮肾活检，患者被诊断为伴有单克隆免疫球蛋白沉积的增生性肾小球肾炎。淋巴结活检显示为滤泡性淋巴瘤。淋巴瘤治疗后尿检结果有所改善。伴有单克隆免疫球蛋白沉积的增生性肾小球肾炎很少被认为与血液系统疾病有关。我们报告一例淋巴瘤相关的伴有单克隆免疫球蛋白沉积的增生性肾小球肾炎，通过游离轻链检测而非电泳检测到轻链异常。
