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Text
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URL Address
<a href="http://doi.org/10.3109/00365599.2011.568954" target="_blank" rel="noreferrer noopener">http://doi.org/10.3109/00365599.2011.568954</a>
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Pages
473-477
Issue
6
Volume
45
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Title
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Waldenstrom's Macroglobulinemia And Nephrotic Syndrome With Membranous Nephropathy
Publisher
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Scandinavian Journal of Urology and Nephrology
Date
A point or period of time associated with an event in the lifecycle of the resource
2011
2011-12
Subject
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antibody; glomerulonephritis; macroglobulinemia; membranous nephropathy; nephrotic syndrome; pathology; Urology & Nephrology; Waldenstrom's
Creator
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Lee B; Smith R S; Tanphaichitr N; Novak R; Robertson S; Haller N A
Description
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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.
Identifier
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<a href="http://doi.org/10.3109/00365599.2011.568954" target="_blank" rel="noreferrer noopener">10.3109/00365599.2011.568954</a>
Format
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Journal Article or Conference Abstract Publication
2011
antibody
Department of Internal Medicine
Glomerulonephritis
Haller N A
Journal Article or Conference Abstract Publication
Lee B
macroglobulinemia
membranous nephropathy
NEOMED College of Medicine
Nephrotic syndrome
Novak R
Pathology
Robertson S
Scandinavian Journal of Urology and Nephrology
Smith R S
Tanphaichitr N
Urology & Nephrology
Waldenstrom's