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.
MeSH terms
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Antibodies, Monoclonal, Murine-Derived / administration & dosage*
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Antineoplastic Combined Chemotherapy Protocols
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Creatinine / blood
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Cyclophosphamide / administration & dosage
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Humans
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Kidney Diseases / etiology*
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Kidney Diseases / pathology
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Kidney Diseases / physiopathology
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Kidney Diseases / therapy*
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Lymphocytes / pathology
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Male
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Middle Aged
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Prednisolone / administration & dosage
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Renal Dialysis
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Rituximab
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Vincristine / administration & dosage
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Waldenstrom Macroglobulinemia / complications*
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Waldenstrom Macroglobulinemia / pathology
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Waldenstrom Macroglobulinemia / physiopathology
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Waldenstrom Macroglobulinemia / therapy*
Substances
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Antibodies, Monoclonal, Murine-Derived
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Rituximab
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Vincristine
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Cyclophosphamide
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Prednisolone
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Creatinine