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Recovery of kidney function by rituximab-based therapy in a patient with Waldenström's macroglobulinemia-related nephropathy presenting cast nephropathy and interstitial lymphocytic infiltration.

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.
AuthorsMasashi Miwa, Yukitoshi Sakao, Sayaka Ishigaki, Masafumi Ono, Tomoyuki Fujikura, Hideo Yasuda, Hiroyuki Suzuki, Akihiko Kato, Yasuyuki Nagata, Kazuyuki Shigeno, Satoki Nakamura, Kazunori Ohnishi, Yoshihide Fujigaki
JournalInternal medicine (Tokyo, Japan) (Intern Med) Vol. 51 Issue 13 Pg. 1725-30 ( 2012) ISSN: 1349-7235 [Electronic] Japan
PMID22790134 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antibodies, Monoclonal, Murine-Derived
  • Rituximab
  • Vincristine
  • Cyclophosphamide
  • Prednisolone
  • Creatinine
Topics
  • Antibodies, Monoclonal, Murine-Derived (administration & dosage)
  • Antineoplastic Combined Chemotherapy Protocols
  • Creatinine (blood)
  • Cyclophosphamide (administration & dosage)
  • Humans
  • Kidney Diseases (etiology, pathology, physiopathology, therapy)
  • Lymphocytes (pathology)
  • Male
  • Middle Aged
  • Prednisolone (administration & dosage)
  • Renal Dialysis
  • Rituximab
  • Vincristine (administration & dosage)
  • Waldenstrom Macroglobulinemia (complications, pathology, physiopathology, therapy)

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