The Second Department of Internal Medicine, University of Toyama, Japan.
Department of Hematology, University of Toyama, Japan.
Intern Med. 2021 Apr 15;60(8):1243-1250. doi: 10.2169/internalmedicine.6099-20. Epub 2020 Oct 28.
Malignant lymphoma is rarely complicated by secondary IgA nephropathy. We encountered a 74-year-old man with rapidly progressive glomerulonephritis due to IgA nephropathy with predominant deposition of IgA2, instead of IgA1, in the glomerulus that was eventually diagnosed as secondary IgA nephropathy due to mantle cell lymphoma. Renal impairment was improved by chemotherapy for the mantle cell lymphoma. IgA came from the colonic mucosa that was stimulated by the infiltrated lymphoma cells, instead of the tumor itself. We should consider mantle cell lymphoma as a cause of secondary IgA nephropathy, although its prevalence may not be very high.
恶性淋巴瘤很少并发继发性 IgA 肾病。我们遇到一位 74 岁男性,因 IgA 肾病导致快速进行性肾小球肾炎,其肾小球中主要沉积的是 IgA2,而非 IgA1,最终诊断为由于套细胞淋巴瘤引起的继发性 IgA 肾病。针对套细胞淋巴瘤的化疗改善了肾功能损害。IgA 来自于受浸润的淋巴瘤细胞刺激的结肠黏膜,而不是肿瘤本身。尽管其发病率可能不是很高,但我们应将套细胞淋巴瘤视为继发性 IgA 肾病的病因之一。