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伴有套细胞淋巴瘤的 IgA 肾病伴 IgA2 沉积为主型

IgA Nephropathy with Dominant IgA2 Deposition Accompanied by Mantle Cell Lymphoma.

机构信息

The Second Department of Internal Medicine, University of Toyama, Japan.

Department of Hematology, University of Toyama, Japan.

出版信息

Intern Med. 2021 Apr 15;60(8):1243-1250. doi: 10.2169/internalmedicine.6099-20. Epub 2020 Oct 28.

DOI:10.2169/internalmedicine.6099-20
PMID:33116018
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8112979/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/86ba482b6c44/1349-7235-60-1243-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/d89d82c4b43f/1349-7235-60-1243-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/7158fc49df7a/1349-7235-60-1243-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/fe7cc3b7b61e/1349-7235-60-1243-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/5ae4ab74167e/1349-7235-60-1243-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/4a8eb8612e18/1349-7235-60-1243-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/a549ac9ad977/1349-7235-60-1243-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/8c2c3ddc7175/1349-7235-60-1243-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/86ba482b6c44/1349-7235-60-1243-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/d89d82c4b43f/1349-7235-60-1243-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/7158fc49df7a/1349-7235-60-1243-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/fe7cc3b7b61e/1349-7235-60-1243-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/5ae4ab74167e/1349-7235-60-1243-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/4a8eb8612e18/1349-7235-60-1243-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/a549ac9ad977/1349-7235-60-1243-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/8c2c3ddc7175/1349-7235-60-1243-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/8112979/86ba482b6c44/1349-7235-60-1243-g008.jpg

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本文引用的文献

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J Assoc Physicians India. 2020 Jan;68(1):75.
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Immunostaining for galactose-deficient immunoglobulin A is not specific for primary immunoglobulin A nephropathy.
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Nephrol Dial Transplant. 2020 Dec 4;35(12):2123-2129. doi: 10.1093/ndt/gfz152.
4
Renal Dysfunction in Patients With Direct Infiltration by B-Cell Lymphoma.B细胞淋巴瘤直接浸润患者的肾功能障碍
Kidney Int Rep. 2019 Feb 12;4(5):688-697. doi: 10.1016/j.ekir.2019.02.008. eCollection 2019 May.
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Mantle cell lymphoma: 2019 update on the diagnosis, pathogenesis, prognostication, and management.套细胞淋巴瘤:2019 年诊断、发病机制、预后和治疗的更新。
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