Long-term clinical course of immunotactoid glomerulopathy complicated with diffuse large B-cell lymphoma.
Aged
Cyclophosphamide
/ therapeutic use
Doxorubicin
/ therapeutic use
Female
Glomerulonephritis
/ drug therapy
Humans
Lymphoma, Large B-Cell, Diffuse
/ complications
Male
Nephrotic Syndrome
/ complications
Prednisolone
/ therapeutic use
Proteinuria
/ drug therapy
Rituximab
/ therapeutic use
Vincristine
/ therapeutic use
Immunotactoid glomerulopathy
Nephrotic syndrome
Journal
CEN case reports
ISSN: 2192-4449
Titre abrégé: CEN Case Rep
Pays: Japan
ID NLM: 101636244
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
received:
01
02
2021
accepted:
15
09
2021
pubmed:
28
9
2021
medline:
6
5
2022
entrez:
27
9
2021
Statut:
ppublish
Résumé
We report a case of immunotactoid glomerulopathy (ITG) complicated with diffuse large B-cell lymphoma (DLBCL). A 68-year-old woman presented with leg edema and was diagnosed with nephrotic syndrome (NS). Renal biopsy revealed ITG. We treated the patient with prednisolone (20 mg/day) and she achieved complete remission of NS. Steroids were gradually reduced. After 1 year, the patient presented with a breast mass determined on biopsy to be DLBCL. She underwent six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) therapy. Follow-up revealed complete remission of both DLBCL and ITG. NS recurred after 5 years and she was simultaneously diagnosed with recurrence of DLBCL in bone marrow. She underwent four cycles of R-EPOCH (rituximab, etoposide, prednisolone, vincristine, cyclophosphamide, doxorubicin) therapy and entered remission for DLBCL. NS improved, but the treatment did not lead to remission. After 2 additional years, NS and DLBCL recurred again. She was administered rituximab and NS improved, although proteinuria tended to increase thereafter. One year later, we started prednisolone (10 mg/day), and proteinuria tended to decrease. She is currently undergoing outpatient follow-up. This case suggests that ITG with MGUS should be treated with the possibility of developing malignant hematological disease during the course.
Identifiants
pubmed: 34569002
doi: 10.1007/s13730-021-00648-0
pii: 10.1007/s13730-021-00648-0
pmc: PMC9061912
doi:
Substances chimiques
Rituximab
4F4X42SYQ6
Vincristine
5J49Q6B70F
Doxorubicin
80168379AG
Cyclophosphamide
8N3DW7272P
Prednisolone
9PHQ9Y1OLM
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
184-190Informations de copyright
© 2021. Japanese Society of Nephrology.
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