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免疫球蛋白 A 血管炎表现的血管免疫母细胞 T 细胞淋巴瘤的延迟诊断。

Delayed diagnosis of angioimmunoblast T-cell lymphoma presenting with immunoglobulin a vasculitis.

机构信息

Department of Hemopurification, Affiliated Hospital of Jining Medical College, Jining, China.

Department of Nephrology, Yanzhou District People's Hospital, Jining City, China.

出版信息

Ren Fail. 2024 Dec;46(2):2416935. doi: 10.1080/0886022X.2024.2416935. Epub 2024 Oct 28.

Abstract

Although vasculitis and renal involvement might be associated with malignancy, they are rarely associated with lymphoproliferative diseases. We observed a case of immunoglobulin A vasculitis associated with segmental and focal glomerulonephritis in a patient with Angioimmunoblastic T-cell lymphoma. The most interesting aspect of this case is that this patient's main initial manifestations were skin rash and fever. No significant lymph node enlargement was found at the time. Routine urine examination found positive urine protein, and renal puncture biopsy indicated purpura nephritis. More than one year later, the patient was admitted to the Department of Hematology of our hospital again after finding a mass in the neck. After that, the patient was diagnosed with Angioimmunoblastic T-cell lymphoma by lymph node biopsy. To our great surprise, successful treatment of the underlying malignancy was associated with the remission of glomerulonephritis and cutaneous vasculitis.

摘要

虽然血管炎和肾脏受累可能与恶性肿瘤有关,但它们很少与淋巴增生性疾病有关。我们观察到一例免疫球蛋白 A 血管炎伴节段性和局灶性肾小球肾炎的患者患有血管免疫母细胞性 T 细胞淋巴瘤。这个病例最有趣的方面是,该患者的主要初始表现为皮疹和发热。当时没有发现明显的淋巴结肿大。常规尿液检查发现尿蛋白阳性,肾穿刺活检提示紫癜性肾炎。一年多后,该患者因颈部发现肿块再次入住我院血液科。此后,患者通过淋巴结活检被诊断为血管免疫母细胞性 T 细胞淋巴瘤。令我们非常惊讶的是,潜在恶性肿瘤的成功治疗与肾小球肾炎和皮肤血管炎的缓解有关。

相似文献

2
Leukocytoclastic vasculitis with IgA deposits in angioimmunoblastic T cell lymphoma.
J Dermatol. 2001 Jan;28(1):32-7. doi: 10.1111/j.1346-8138.2001.tb00083.x.

本文引用的文献

3
IgA vasculitis.IgA 血管炎。
Semin Immunopathol. 2021 Oct;43(5):729-738. doi: 10.1007/s00281-021-00874-9. Epub 2021 Jun 25.
6
Angioimmunoblastic T-cell lymphoma: the many-faced lymphoma.血管免疫母细胞性 T 细胞淋巴瘤:多面性淋巴瘤。
Blood. 2017 Mar 2;129(9):1095-1102. doi: 10.1182/blood-2016-09-692541. Epub 2017 Jan 23.

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