Morita H, Shinzato T, Maeda K
Department of Internal Medicine, Branch Hospital of Nagoya University, School of Medicine.
Nihon Rinsho. 1995 Aug;53(8):2007-12.
This paper describes tubulointerstitial changes of the kidney in association with a) pathophysiology of paraproteinuria and related disorders, and b) the management of leukemia and malignant lymphoma. Various forms of tubulointerstitial changes might be provoked following the accumulation of "abnormal macromolecules" In a), multiple myeloma, light chain cast nephropathy (myeloma kidney), AL amyloidosis, light chain deposition disease, macroglobulinemia, cryoglobulinemia etc. are briefly reviewed. In the majority of cases, leukemia and lymphoma do not manifest themselves as tubulointerstitial disorders. However, a large number of patients suffer from tubulointerstitial abnormalities in the course of and/or after receiving chemotherapy. Thus it is explained, in b), why treatment for hematological malignancy is apt to induce tubulointerstitial complications. In this context, drugs responsible for the development of tubulitis and/or interstitial fibrosis are briefly reviewed.
a）副蛋白血症及相关病症的病理生理学，以及b）白血病和恶性淋巴瘤的治疗。在a）中，“异常大分子”积累后可能引发各种形式的肾小管间质变化，简要回顾了多发性骨髓瘤、轻链管型肾病（骨髓瘤肾）、AL淀粉样变性、轻链沉积病、巨球蛋白血症、冷球蛋白血症等。在大多数情况下，白血病和淋巴瘤并不表现为肾小管间质疾病。然而，大量患者在化疗过程中和/或化疗后会出现肾小管间质异常。因此，在b）中解释了血液系统恶性肿瘤的治疗为何容易引发肾小管间质并发症。在此背景下，简要回顾了导致肾小管炎和/或间质纤维化的药物。
