Antineutrophil cytoplasmic antibody-positive pauci-immune glomerulonephritis associated with mantle cell lymphoma

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Abstract

Renal involvement in non-Hodgkin lymphoma, especially mantle cell lymphoma (MCL) is rare. A 77-year-old man presented with acute kidney injury (AKI), which rapidly progressed to dialysis dependence. Kidney biopsy revealed patchy B-cell lymphocytic aggregates in the interstitium, which were positive for cyclin D1, consistent with atypical CD5-negative MCL as confirmed by the detection of translocation t(11;14) by FISH. Crescents were noted in 3 of 26 glomeruli; while PR-3 antineutrophil cytoplasmic antibody (ANCA) positivity and negative immunofluorescence suggested an additional pauci-immune (rapidly progressive) glomerulonephritis pattern of injury. Patient received chemotherapy (cyclophosphamide, vincristine, and prednisone), which improved his renal function and allowed for discontinuation of hemodialysis. However, he died from pulmonary hemorrhage 8 months after initial presentation. This is the first reported case of a patient with coexistence of renal MCL infiltration and ANCA-positive pauci-immune glomerulonephritis.

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Incidence trends of mantle cell lymphoma in the United States between 1992 and 2004.

Yuhong Zhou, Haijun Wang, Wenjing Fang … (2008)

Mantle cell lymphoma (MCL) is a distinct subtype of B-cell non-Hodgkin's lymphoma. To the authors' knowledge, little is known regarding its incidence patterns and associated factors. The purpose of the current study was to examine the incidence of MCL over a period of 13 years and to identify the factors associated with the incidence patterns. Patients diagnosed with MCL between 1992 and 2004 were identified from the Surveillance, Epidemiology, and End Results (SEER) Tumor registries. SEER*Stat statistical software was used for analysis. Of the 87,166 patients diagnosed with non-Hodgkin's lymphoma during the 13-year period between 1992 and 2004, 2459 (2.8%) had confirmed MCL. The overall incidence of MCL (per 100,000) was 0.55, which increased with age: 0.07 in patients aged or =80 years. The age-adjusted incidence rate increased from 0.27 of 100,000 in 1992 to 0.69 of 100,000 in 2004, and the annual percent change was 5.87% (P or =50 years. Most patients were diagnosed with late-stage MCL, and there also were considerable geographic variations observed in incidence rate. 2008 American Cancer Society

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Renal lesions associated with malignant lymphomas.

John R. Richmond, Robert S. Sherman, Henry D. Diamond … (1962)

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Kidney involvement in leukemia and lymphoma.

Randy Luciano, Ursula Brewster (2014)

Leukemia and lymphoma are hematologic malignancies that can affect any age group. Disease can be aggressive or indolent, often with multiorgan system involvement. Kidney involvement in leukemia and lymphoma can be quite extensive. Acute kidney injury (AKI) is quite prevalent in these patients, with prerenal and acute tubular necrosis being the most common etiologies. However other prerenal, intrinsic, and obstructive etiologies are possible. AKI can be a direct effect of the malignancy, a complication of the malignancy, or the consequence or side effect of chemotherapy. Nephrotic syndrome and glomerulonephritis, often presenting without overt kidney failure, have also been seen in all forms of leukemia and lymphoma. Lastly, the direct effects of the malignancy and complications from the tumor often result in numerous electrolyte disturbances and acid-base disorders, with life-threatening consequences if left untreated.

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Author and article information

Journal

Journal ID (nlm-ta): Clin Nephrol Case Stud

Journal ID (iso-abbrev): Clin Nephrol Case Stud

Journal ID (publisher-id): Dustri

Title: Clinical Nephrology. Case Studies

Publisher: Dustri-Verlag Dr. Karl Feistle

ISSN (Electronic): 2196-5293

Publication date Collection: 2017

Publication date (Electronic): 3 February 2017

Volume: 5

Pages: 9-15

Affiliations

[1 ]Department of Internal Medicine, Division of Nephrology and Hypertension,

[2 ]Department of Pathology, Mount Sinai Beth Israel, New York, NY, and

[3 ]Department of Internal Medicine, Division of Nephrology and Hypertension, Harbor UCLA Medical Center, Torrance, CA, USA

Author notes

Kana Miyata Department of Internal Medicine, Division of Nephrology and Hypertension, Harbor UCLA Medical Center, 1124 W. Carson Street, Torrance, CA90502, USA kananoshiro@ 123456gmail.com

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DOI: 10.5414/CNCS109036

PMC ID: 5438003

SO-VID: 152014c7-abdb-4330-9bae-3a0b7a328069

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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Antineutrophil cytoplasmic antibody-positive pauci-immune glomerulonephritis associated with mantle cell lymphoma

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Karger: Nephrology

Most cited references 26

Incidence trends of mantle cell lymphoma in the United States between 1992 and 2004.

Renal lesions associated with malignant lymphomas.

Kidney involvement in leukemia and lymphoma.

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