Harada Yukinori, Sakai Kei, Asaka Shiho, Nakayama Kazutaka
Department of Internal Medicine, Nagano Chuo Hospital, Japan.
Intern Med. 2017;56(1):85-89. doi: 10.2169/internalmedicine.56.7315. Epub 2017 Jan 1.
Few cases of IgA nephropathy with angioimmunoblastic T-cell lymphoma (AITL) have been reported. We herein present the case of a 79-year-old Japanese man with AITL and IgA nephropathy. The patient presented with generalized edema, fatigue, and fever. Laboratory investigations revealed polyclonal gammopathy with a high level of IgA, microscopic hematuria, proteinuria, and some other immunological abnormalities. Computed tomography revealed generalized lymphadenopathy. A diagnosis of AITL and IgA nephropathy was made based on inguinal lymph node and renal biopsies. Following chemotherapy for AITL, the patient's edema, microscopic hematuria, and proteinuria were alleviated. These findings indicate that IgA nephropathy may occur in AITL patients.
IgA肾病合并血管免疫母细胞性T细胞淋巴瘤(AITL)的病例报道较少。我们在此报告一例79岁的日本男性AITL合并IgA肾病患者。患者出现全身水肿、乏力和发热。实验室检查发现多克隆丙种球蛋白病,伴有高水平的IgA、镜下血尿、蛋白尿以及其他一些免疫异常。计算机断层扫描显示全身淋巴结肿大。根据腹股沟淋巴结活检和肾活检结果诊断为AITL和IgA肾病。对AITL进行化疗后,患者的水肿、镜下血尿和蛋白尿得到缓解。这些发现表明AITL患者可能会发生IgA肾病。