伴有淋巴瘤肾脏浸润的抗LRP2肾病

Gamayo Ashley, Hecox Douglas, Dicker Lance, Vecchiarelli Lisa, Raess Philipp W, Khalighi Mazdak, Andeen Nicole K

Department of Pathology, Oregon Health & Science University, Portland, OR, USA.

Renal Care Consultants, Medford, OR, USA.

Clin Kidney J. 2019 Dec 22;13(3):468-472. doi: 10.1093/ckj/sfz166. eCollection 2020 Jun.

Anti-low-density lipoprotein receptor-related lipoprotein 2 (LRP2) nephropathy/anti-brush border antibody disease is rare and characterized by tubular basement membrane, Bowman's capsule and glomerular subepithelial immune deposits on kidney biopsy. No reported cases have occurred in patients with lymphoproliferative disorders or monoclonal gammopathies. We present two cases of anti-LRP2 nephropathy that occurred in patients with progressive low-grade B-cell lymphoma and had concurrent kidney infiltration by lymphoma on biopsy. We speculate that underlying immune dysregulation related to lymphoma may contribute to the development of this rare autoimmune kidney disease in some patients.

抗低密度脂蛋白受体相关蛋白2（LRP2）肾病/抗刷状缘抗体病较为罕见，其特征为肾活检时肾小管基底膜、鲍曼囊和肾小球上皮下免疫沉积物。在淋巴增殖性疾病或单克隆丙种球蛋白病患者中尚未有病例报道。我们报告了两例抗LRP2肾病，发生于进展性低度B细胞淋巴瘤患者，活检显示淋巴瘤同时浸润肾脏。我们推测，与淋巴瘤相关的潜在免疫失调可能在某些患者中促成了这种罕见的自身免疫性肾病的发生。