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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.

DOI:10.1080/0886022X.2024.2416935
PMID:39465652
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11520118/
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。

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本文引用的文献

1
Rapidly progressive glomerulonephritis in a patient with angioimmunoblastic T-cell lymphoma: a rare autopsy case showing IgA vasculitis and cylinder-like deposits.免疫母细胞性 T 细胞淋巴瘤患者的急进性肾小球肾炎:一例罕见尸检病例表现为 IgA 血管炎和管状沉积。
Med Mol Morphol. 2022 Sep;55(3):267-273. doi: 10.1007/s00795-022-00325-w. Epub 2022 Jun 3.
2
Recent Advances in Diagnosis and Therapy of Angioimmunoblastic T Cell Lymphoma.血管免疫母细胞性 T 细胞淋巴瘤的诊断和治疗进展。
Curr Oncol. 2021 Dec 20;28(6):5480-5498. doi: 10.3390/curroncol28060456.
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.
4
Delayed diagnosis of Angioimmunoblast T-cell lymphoma presenting with type II Cryoglobulinemia and acute kidney injury: a case report and narrative review of the literature.血管免疫母细胞 T 细胞淋巴瘤伴 II 型冷球蛋白血症和急性肾损伤的延迟诊断:病例报告及文献综述。
BMC Nephrol. 2020 Nov 7;21(1):463. doi: 10.1186/s12882-020-02125-9.
5
The Role of IgA in the Pathogenesis of IgA Nephropathy.IgA 在 IgA 肾病发病机制中的作用。
Int J Mol Sci. 2019 Dec 9;20(24):6199. doi: 10.3390/ijms20246199.
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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.
7
A male with angioimmunoblastic T-cell lymphoma and proliferative glomerulonephritis.一名患有血管免疫母细胞性T细胞淋巴瘤和增殖性肾小球肾炎的男性。
Ann Hematol. 2004 Jul;83(7):455-9. doi: 10.1007/s00277-003-0828-5. Epub 2004 Mar 18.
8
Selective deposition of immunoglobulin A1 in immunoglobulin A nephropathy, anaphylactoid purpura nephritis, and systemic lupus erythematosus.免疫球蛋白A1在IgA肾病、过敏性紫癜性肾炎和系统性红斑狼疮中的选择性沉积。
J Clin Invest. 1980 Dec;66(6):1432-6. doi: 10.1172/JCI109998.