nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical Universitynefr-241Research ArticleНАБЛЮДЕНИЯ ИЗ ПРАКТИКИPRACTICAL NOTESФОКАЛЬНО-СЕГМЕНТАРНЫЙ ГЛОМЕРУЛОСКЛЕРОЗ, АССОЦИИРОВАННЫЙ С ХРОНИЧЕСКИМ ЛИМФОЛЕЙКОЗОМ: КЛИНИЧЕСКИЙ СЛУЧАЙ И ЛИТЕРАТУРНЫЙ ОБЗОРFOCAL SEGMENTAL GLOMERULOSCLEROSIS ASSOCIATED WITH CHRONIC LYMPHOCYTIC LEUKAEMIA: CASE REPORT AND LITERATURE REVIEWАниконоваЛ. И.AnikonovaL. I.

Аниконова Людмила Ивановна, кандидат медицинских наук, доцент.

Кафедра внутренних болезней и нефрологии.

192283, Санкт-Петербург, ул. Олеко Дундича, д. 8, корп. 2.

Associate prof. Liudmila I. Anikonova MD PhD.

Department of internal diseases and nephrology. 

195067, Russia, St. Petersburg, Piskarevskij prospect, 47 

anikonovaspb@mail.ruРяснянскийВ. Ю.RyasnyanskiyV. U.

Ряснянский Владимир Юрьевич, кандидат медицинских наук, доцент.

Кафедра внутренних болезней и нефрологии.

192283, Санкт-Петербург, ул. Олеко Дундича, д. 8, корп. 2.

Associate prof. Vladimir Iu. Ryasnyanskiy MD, PhD. 

Department of internal diseases and nephrology. 

195067, Russia, St. Petersburg, Piskarevskij prospect, 47 

 

 

ryasn2006@rambler.ruМакарьеваЕ. Ю.MakarjyevaE. U.

Макарьева Екатерина Юрьевна, больничный ординатор отделения диализа № 2 кафедры внутренних болезней и нефрологии. 

195067, Санкт-Петербург, Пискаревский пр., д. 47. 

ВоробьеваО. А.VorobjyеvaO. A.

Воробьева Ольга Алексеевна, кандидат медицинских наук. 

192283, Санкт-Петербург, ул. Олеко Дундича, д. 8, корп. 2

Olga A. Vorobyеva MD PhD 

192283, Russia St. Petersburg Oleko Dundich str. 8 cor. 2 

olgavor1970@yahoo.comСеверо-Западный государственный медицинский университет им. И.И.МечниковаРоссияNorth-Western State Medical University named after I.I.MechnikovRussian FederationНациональный центр клинической морфологической диагностикиРоссияEkaterina U. Makaryeva MD. Department of internal diseases and nephrology divission of dialysis №2. 195067, Russia, St. Petersburg, Piskarevskij prospect, 47Russian FederationНациональный центр клинической морфологической диагностикиРоссияNational center of clinical and morphological diagnosticsRussian Federation201603032017206101110Copyright © Аниконова Л.И., Ряснянский В.Ю., Макарьева Е.Ю., Воробьева О.А., 20172017Аниконова Л.И., Ряснянский В.Ю., Макарьева Е.Ю., Воробьева О.А.Anikonova L.I., Ryasnyanskiy V.U., Makarjyeva E.U., Vorobjyеva O.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/241

Хронический лимфолейкоз (ХЛЛ) – самый частый вид лейкозов в Западной Европе. Несмотря на относительную частоту этого вида лейкоза, публикации о поражении почек при ХЛЛ встречаются редко. Нефробиопсии рутинно не выполняются этим больным при появлении нефротического синдрома или неясной почечной недостаточности, в результате о механизмах почечного поражения при ХЛЛ известно мало. К настоящему времени в литературе описано всего около 130 случаев гломерулярных и интерстициальных поражений почек при ХЛЛ, подтвержденных результатами нефробиопсий. Наиболее частой формой гломерулопатии, вызывающей нефротический синдром при ХЛЛ, является мембранно-пролиферативный гломерулонефрит, реже встречаются болезнь минимальных изменений, мембранозная нефропатия; фокально-сегментарный гломерулосклероз (ФСГС) является редкостью, и к настоящему времени опубликовано 6 случаев ФСГС, ассоциированного с ХЛЛ. Мы представляем клинический случай, описывающий пациента, страдавшего ХЛЛ, у которого развился нефротический синдром, вызванный ФСГС, успешно леченный ритуксимабом , а также литературный обзор по паранеопластическим гломерулопатиям, ассоциированных с ХЛЛ, проявляющимся нефротическим синдромом.

Chronic lymphocytic leukemia (CLL) is the most frequent form of leukemia inWestern Europe. Despite of high frequency of this type of leukemia, kidney involvement associated with CLL is rarely reported in the literature. Renal biopsies are not routinely performed in patients with CLL to evaluate unexplained renal insufficiency or nephrotic syndrome (NS). As a consequence, little is known about mechanisms causing renal abnormalities in CLL. Collectively, 130 cases of biopsy-proven glomerular or interstitial renal abnormalities due to CLL have been reported in the literature to date. The most common type of glomerulonephritis causing NS during CLL is membranoproliferative glomerulonephritis, less frequent causes include membranous nephropathy, minimal-change disease. Focal segmental glomerulosclerosis (FSGS) is a rarity; we met only 6 observations of FSGS associated with CLL that have been published to date. We present a rare case of CLL-associated FSGS with clinical resolution of the NS after successful treatment with rituximab and literature review on various nephrotic glomerulonephropathies associated with CLL manifestative with NS.

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The authors declare that there are no conflicts of interest present.