Waldenstrom's Macroglobulinemia And Nephrotic Syndrome With Membranous Nephropathy
antibody; glomerulonephritis; macroglobulinemia; membranous nephropathy; nephrotic syndrome; pathology; Urology & Nephrology; Waldenstrom's
Renal complications of Waldenstrom's macroglobulinemia (WM) are rarely observed. Nephrotic syndrome in association with WM has most often been secondary to amyloidosis. This article reports a case of WM with nephrotic syndrome as a result of membranous nephropathy with immunoglobulin M (IgM) deposition. A 44-year-old male diagnosed with WM 4 years previously, presented with heavy proteinuria (7.8 g/24 h). Kidney biopsy revealed expanded mesangium, thickened capillary loops and epimembranous spikes, with no significant interstitial inflammation or thickened tubular basement membranes. Immunofluorescence examination demonstrated strong granular staining of IgM and l light chains, with weaker C3 and C1q staining. Electron microscopy showed many subepithelial dense deposits, and fewer large subendothelial dense deposits. Treatment was directed at the patient's WM with maintenance rituximab and fludarabine. Subsequently, decreases were seen in both the patient's serum IgM and serum viscosity. With therapy for WM and the addition of an angiotensin receptor blocker, the patient's proteinuria also improved, from 7.8 g to 4.8 g/24 h. The patient continued to follow up with his hematologist and in 2009 creatinine was 1 mg/dl (76.26 mu mol/l), with a 24 h urine protein excretion of 0.159 g.
Lee B; Smith R S; Tanphaichitr N; Novak R; Robertson S; Haller N A
Scandinavian Journal of Urology and Nephrology
2011
2011-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.3109/00365599.2011.568954" target="_blank" rel="noreferrer noopener">10.3109/00365599.2011.568954</a>
From research literature to the clinical laboratory, problems in translation
Pathology; Research & Experimental Medicine
Novak R
Laboratory Investigation
2001
2001-01
Journal Article
n/a
Crescentic glomerulonephritis in the pediatric population
Pathology
Novak R; Agamanolis D; Dresner I
Modern Pathology
1998
1998-01
Journal Article
n/a
Fibrillary glomerulonephritis with hepatitis C viral infection and hypocomplementemia
deposits; entity; features; fibrillary glomerulonephritis; hepatitis C infection; hypocomplementemia; immunofluorescence; immunotactoid glomerulopathy; Urology & Nephrology
Fibrillary glomerulonephritis (FGN) is a relatively rare cause of renal disease, found in only 0.6-1.5% of native renal biopsies. The pathogenesis of FGN is not well described, and very few associations with disease processes other than hepatitis C virus (HCV) have been made. We describe a case that provides evidence in support of the FGN-HCV association, as well as introduces the association of FGN-HCV and hypocomplementemia. The case is a 53-year-old African-American female demonstrating a classical presentation of FGN complicated by a concomitant HCV infection. Treating an HCV infection with alpha-interferon has been shown to result in subsequent improvement in the nephrotic syndrome and renal function. However, this patient is unique in that she is complicated with hypocomplementemia, creating a complex treatment situation.
Ray S; Rouse K; Appis A; Novak R; Haller N A
Renal Failure
2008
2008
Journal Article
<a href="http://doi.org/10.1080/08860220802213062" target="_blank" rel="noreferrer noopener">10.1080/08860220802213062</a>
Trisomy 8 is a characteristic finding in pleuropulmonary blastoma
aberrations; childhood; chromosomal-abnormalities; mosaicism; Pathology; Pediatrics; pleuropulmonary blastoma; pulmonary blastoma; trisomy 8; tumors
The cytogenetic findings in pleuropulmonary blastoma (PPB) have not been widely studied and reported and are of interest in view of the implications that PPB has for additional tumors in the patient and the patient's relatives. Using standard tumor cytogenetic methodology, we investigated three cases of PPB encountered in our institution over a 5-year period. Trisomy 8 was the only karyotypic abnormality in a localized type 2 PPB and was present with other abnormalities in another type 2 PPB and a massive type 3 PPB. Review of the literature yielded three additional karyotyped PPBs; all had trisomy 8 as part of the abnormalities detected. Trisomy 8 appears to be a characteristic of PPB and may be related to the development of PPB and related tumors.
Novak R; Dasu S; Agamanolis D; Herold W; Malone J; Waterson J
Pediatric Pathology & Laboratory Medicine
1997
1997-01
Journal Article
<a href="http://doi.org/10.1080/107710497175056" target="_blank" rel="noreferrer noopener">10.1080/107710497175056</a>