Recovery of Kidney Function by Rituximab-based Therapy in a Patient with Waldenström's Macroglobulinemia-related Nephropathy Presenting Cast Nephropathy and Interstitial Lymphocytic Infiltration
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- Miwa Masashi
- Internal Medicine I, Division of Nephrology, Hamamatsu University School of Medicine, Japan
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- Sakao Yukitoshi
- Internal Medicine I, Division of Nephrology, Hamamatsu University School of Medicine, Japan
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- Ishigaki Sayaka
- Internal Medicine I, Division of Nephrology, Hamamatsu University School of Medicine, Japan
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- Ono Masafumi
- Internal Medicine I, Division of Nephrology, Hamamatsu University School of Medicine, Japan
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- Fujikura Tomoyuki
- Internal Medicine I, Division of Nephrology, Hamamatsu University School of Medicine, Japan
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- Yasuda Hideo
- Internal Medicine I, Division of Nephrology, Hamamatsu University School of Medicine, Japan
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- Suzuki Hiroyuki
- Internal Medicine I, Division of Nephrology, Hamamatsu University School of Medicine, Japan
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- Kato Akihiko
- Division of Blood Purification Unit, Hamamatsu University School of Medicine, Japan
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- Nagata Yasuyuki
- Internal Medicine III, Division of Hematology, Hamamatsu University School of Medicine, Japan
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- Shigeno Kazuyuki
- Internal Medicine III, Division of Hematology, Hamamatsu University School of Medicine, Japan
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- Nakamura Satoki
- Internal Medicine III, Division of Hematology, Hamamatsu University School of Medicine, Japan
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- Ohnishi Kazunori
- Internal Medicine III, Division of Hematology, Hamamatsu University School of Medicine, Japan
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- Fujigaki Yoshihide
- Internal Medicine I, Division of Nephrology, Hamamatsu University School of Medicine, Japan
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Abstract
A 60-year-old man with Waldenström's macroglobulinemia (WM) was admitted to our hospital for evaluation of rapid progressive renal deterioration despite 3 cycles of oral melphalan and prednisolone (MP) therapy. Renal biopsy just before introducing hemodialysis revealed cast nephropathy and severe tubulo-interstitial infiltration of B lymphocytes. After 6 cycles of rituximab, cyclophosphamide, vincristine and prednisolone (R-COP) therapy, his renal function improved enough to discontinue hemodialysis. This is a rare case of WM-related renal involvement caused by both monoclonal protein and tumor infiltration and, to our knowledge, the second report on improved renal function by rituximab-based therapy.<br>
Journal
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- Internal Medicine
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Internal Medicine 51 (13), 1725-1730, 2012
The Japanese Society of Internal Medicine