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Case Reports
. 2024 Dec;17(4):237-244.
doi: 10.1007/s12308-024-00596-5. Epub 2024 Jul 20.

Paraneoplastic glomerulonephritis and kidney infiltration by mantle cell lymphoma: A diagnostic challenge

Ana Lerma-Verdejo  1 , Maribel Monroy-Condori  2 , Xavier E Guerra-Torres  2 , Nahir Daniela Moreno Paredes  3 , Anastasio Serrano Egea  4 , Francisco Díaz  5 , Jorge L Morales-Montoya  2 , Jacobo Galán Vega  3 , Iván Arenas-Moncaleano  2 , Fernando Solano Ramos  3
Affiliations
Case Reports

Paraneoplastic glomerulonephritis and kidney infiltration by mantle cell lymphoma: A diagnostic challenge

Ana Lerma-Verdejo et al. J Hematop. 2024 Dec.

Abstract

Mantle cell lymphoma (MCL) is a rare and aggressive type of lymphoma that can affect the kidneys. The disease can lead to kidney impairment, and glomerulonephritis (GN) is a rare but serious complication of MCL. We report a case of MCL with kidney interstitial infiltration and membranoproliferative glomerulonephritis with focal and segmental glomerulosclerosis. A 75-year-old man presented recurrent acute kidney failure and worsening of nephrotic syndrome. Kidney biopsy revealed membranoproliferative glomerulonephritis presented immunoglobulin and complement deposition, focal and segmental glomerulosclerosis of not otherwise specified type, and infiltration by mantle cell lymphoma. Bone marrow biopsy and PET/CT scan confirmed the diagnosis of mantle cell lymphoma. The patient was treated with R-CHOP21 chemotherapy with cyclophosphamide dose adjustment for nephroprotection. He achieved complete remission with normalization of hematological parameters, improvement of kidney function, and reduction of proteinuria and albuminuria. This case shows the importance of considering alternative diagnoses in patients with recurrent chronic kidney disease and worsening nephrotic syndrome. Early diagnosis and treatment of mantle cell lymphoma can lead to favorable outcomes.

Keywords: Kidney infiltration; Mantle cell lymphoma; Membranoproliferative glomerulonephritis; Nephrotic syndrome.

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Conflict of interest statement

Declarations. Ethics approval: All the procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent: The patient gave his consent for the publication of these images. Consent for publication: The patient gave his consent for the publication of these images. Conflict of interest: The authors declare no competing interests.

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