Mini review: A unique case of crescentic C3 glomerulonephritis

Kidney involvement is an under‐recognized complication of non‐Hodgkin lymphomas. They occur in a variety of mechanisms and differ widely in their clinical presentation. We take this opportunity to report a case of a 65 year‐old man who developed a rapidly progressive glomerulonephritis within days a...

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Bibliographic Details
Published in:Nephrology (Carlton, Vic.) Vic.), 2017-03, Vol.22 (3), p.261-264
Main Authors: Palamuthusingam, Dharmenaan, Mantha, Murty, Oliver, Kimberley, Bavishi, Ketan, Dheda, Shyam
Format: Article
Language:English
Subjects:
acute kidney injury
Aged
Biopsy
Case reports
Chemotherapy
Clonal deletion
Complement component C3
Cyclophosphamide
Dialysis
Doxorubicin
Gene deletion
Genetic screening
Glomerulonephritis
Glomerulonephritis, Membranoproliferative - diagnosis
Glomerulonephritis, Membranoproliferative - etiology
Humans
Immunosuppression
Kidney transplantation
Lymphoma
Lymphoma, Mantle-Cell - complications
Lymphoma, Mantle-Cell - drug therapy
Lymphoma, Mantle-Cell - pathology
Male
Mantle cell lymphoma
Monoclonal antibodies
Prednisolone
Proteinuria
Rituximab
Targeted cancer therapy
Urine
Vincristine
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Summary:Kidney involvement is an under‐recognized complication of non‐Hodgkin lymphomas. They occur in a variety of mechanisms and differ widely in their clinical presentation. We take this opportunity to report a case of a 65 year‐old man who developed a rapidly progressive glomerulonephritis within days after completing his first cycle of R‐CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisolone) chemotherapy for newly diagnosed mantle cell lymphoma. He was odematous, hypertensive, oliguric with nephrotic range proteinuria and an active urine sediment. A renal biopsy showed a crescentic C3 glomerulonephritis (C3GN) with no evidence endocapillary or mesangial hypercellularity. He was promptly treated with immunosuppression and dialysis, with resumption of his chemotherapy. Genetic testing on complement proteins revealed a homozygous deletion spanning the CFHR1 and CFHR3 genes. Crescentic C3GN is a rare form of kidney injury, and this is the first known case of lymphoma‐associated kidney involvement manifesting as C3GN. This article explores the possible mechanism of disease and reviews the literature of lymphoma‐related kidney disease.
ISSN:1320-5358
1440-1797
DOI:10.1111/nep.12925