FOCAL SEGMENTAL GLOMERULOSCLEROSIS ASSOCIATED WITH CHRONIC LYMPHOCYTIC LEUKAEMIA: CASE REPORT AND LITERATURE REVIEW
Abstract
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.
About the Authors
L. I. Anikonova
North-Western State Medical University named after I.I.Mechnikov
Russian Federation
Russian Federation
Associate prof. Liudmila I. Anikonova MD PhD.
Department of internal diseases and nephrology.
195067, Russia, St. Petersburg, Piskarevskij prospect, 47
V. U. Ryasnyanskiy
North-Western State Medical University named after I.I.Mechnikov
Russian Federation
Russian Federation
Associate prof. Vladimir Iu. Ryasnyanskiy MD, PhD.
Department of internal diseases and nephrology.
195067, Russia, St. Petersburg, Piskarevskij prospect, 47
E. U. Makarjyeva
Ekaterina U. Makaryeva MD.
Department of internal diseases and nephrology divission of dialysis №2.
195067, Russia, St. Petersburg, Piskarevskij prospect, 47
Russian Federation
Russian Federation
O. A. Vorobjyеva
National center of clinical and morphological diagnostics
Russian Federation
Russian Federation
Olga A. Vorobyеva MD PhD
192283, Russia St. Petersburg Oleko Dundich str. 8 cor. 2
References
1. Российские клинические рекомендации по диагностике и лечению лимфопролиферативных заболеваний. Под руководством проф. ИВ Поддубной, проф. ВГ Савченко. Медиа Медика, М., 2013; 108-118 [Rossii`skie clinicheskie rekomendatcii po diagnostike i lecheniiu limfoproliferativny`kh zabolevanii`. Pod rukovodstvom prof. IV Poddubnoi`, prof. VG Savchenko. M.: Media Medika, 2013; 108-118]
2. Радченко ВГ, Аниконова ЛИ, Полякова ВВ. Поражение почек при множественной миеломе и моноклональных гаммапатиях почечного значения (научный обзор). Профилактическая и клин мед 2014; 4 (53): 97-106 [Radchenko VG, Anikonova LI, Poliakova VV. Porazhenie pochek pri mnozhestvennoi` mielome i monoclonal`ny`kh gammapatiiakh pochechnogo znacheniia (nauchny`i` obzor). Profilakticheskaia i clinicheskaia meditcina 2014; 4 (53): 97-106]
3. Strati P, Nasr SH, Leung N et al. Renal complications in chronic lymphocytic leukemia and monoclonal B-cell lymphocytosis: the Mayo Clinic experience. Haematologica 2015; 100(9). doi:10.3324/haematol.2015.128793
4. Poitou-Verkinder AL, Francois A, Drieux F et al. The spectrum of kidney pathology in B-cell chronic lymphocytic leukemia / small lymphocytic lymphoma: a 25-year multicenter experi ence. PLoS One 2015; 10 (3): e0119156. doi:10.1371/journal.pone. 0119156
5. Arampatzis S, Giannakoulas N, Liakopoulos V et al. Simultaneous clinical resolution of focal segmental glomerulosclerosis associated with chronic lymphocytic leukaemia treated with fludarabine, cyclophosphamide and rituximab. BMC Nephrol 2011; 12:33
6. Ronco PM. Nephrology Forum: Paraneoplastic glomerulopathies: new insights into an old entity. Kidney Int 1999; 56: 355-377
7. Moulin B, Ronco PM, Mougenot B et al. Glomerulonephritis in chronic lymphocytic leu kemia and related B-cell lymphoma. Kidney Int 1992; 42:127–135
8. Kowalewska J, Nicosia RF, Smith KD et al. Patterns of glomerular injury in kidneys infil trated by lymphoplasmacytic neoplasms. Hum Pathol 2011; 42(6):896–903. doi: 10.1016/j. humpath.2010.09.009
9. Da’as N, Polliack A, Cohen Y et al. Kidney involvement and renal manifestations in non-Hodgkin’s lymphoma and lymphocytic leukemia: a retrospective study in 700 patients. Eur J Hematol 2001; 67:158–164
10. Latcha S, Sechan SV. Paraneoplastic Glomerulopathy. In: Finkel KW, Howard SC, eds. Renal Disease in Cancer Patients, 1st ed. Academic Press, New York, 2013; 209-249
11. Eagen JW, Lewis EJ. Glomerulopathies of neoplasia. Kidney Int 1977; 11:297–306
12. Alpers CE, Cotran RS. Neoplasia and glomerular injury. Kidney Int 1986; 30:465–473
13. Moulin B, Chantrel F, Petitjean P et al. Chronic lymphoproliferative disorders and glomerular diseases: Review of the literature and pathophysiologic considerations. J Nephrol 1995; 8:20–26
14. Seney FD, Federgreen WR, Stein H et al. A review of nephrotic syndrome as sociated with chronic lymphocytic leukemia. Arch Intern Med 1986; 146:137–141
15. Touchard G, Preud’homme JL, Aucouturier P et al. Nephrotic syndrome associated with chronic lymphocytic leukemia: An immunological and pathological study. Clin Nephrol 1989; 31:107–116
16. Cameron S, Ogg CS. Nephrotic syndrome in chronic lymphatic leukaemia. Br Med J 1974; 4:164
17. Ziakas PD, Giannouli S, Psimenou E et al. M. Membranous glomerulonephritis in chronic lymphocytic leukemia. Am J Hematol 2004; 76(3):271–274
18. Row PG, Cameron JS, Turner DR et al. Membranous nephropathy. Long-term follow up and association with neoplasia. Q J Med 1975; 44:207–239
19. White CA, Dillman RO, Royston I. Membranous nephropathy associated with an unusual phenotype of chronic lymphocytic leukemia. Cancer 1983; 52:2253–2255
20. Eisterer W, Neyer U, Hilbe W, et al. Effect of cyclosporin A in a patient with refractory nephrotic syndrome associated with B chronic lymphocytic leukemia. Nephron 1996; 72: 468–471
21. Butty H, Asfoura J, Cortese F et al. Chronic lymphocytic leukemia-as sociated membranous glomerulopathy: remission with fludarabine. Am J Kidney Dis 1999; 33:E8
22. Abdel-Raheem MM, Jamil MG, Potti A et al. Fludarabine therapy in chronic lym phocytic leukemia associated severe nephrotic syndrome. Hematologica 2000; 85(11): 1224–1225
23. Kofman T, Zhang SY, Copie-Bergman C et al. Minimal Change Nephrotic Syndrome Associated With Non-Hodgkin Lymphoid Disorders. Medicine 2014;93:350–358 DOI: 10.1097/ MD.0000000000000206
24. Dabbs DJ, Striker LM, Mignon F et al. Glomerular lesions in lymphomas and leukemias. Am J Med 1986; 80:63–70. PMID: 3510541
25. Sanchorawala V, Blanchard E, Seldin DC et al. AL amyloidosis associated with B-cell lymphoproliferative disorders: frequency and treatment outcomes. Am J Hematol 2006; 81:692– 695. PMID: 16795060
26. Dou X, Hu H, Ju Y et al. Systemic amyloidosis associated with chronic lympho cytic leukemia/small lymphocytic lymphoma. Am J Hematol 2013; 88: 375–378. doi: 10.1186/1746-1596-6-99
27. Sethi S, Fervenza FC, Zhang YZ et al. Proliferative Glomerulonephritis secondary to dys function of the alternative pathway of complement. Clin J Am Soc Nephrol 2011; 6(5):1009-1017
28. Barbour SJ, Beaulieu MC, Zalunardo NY et al. Proliferative glomerulonephritis with monoclonal IgG deposits secondary to chronic lymphocytic leukemia. Report of two cases. Nephrol Dial Transplant 2011; 26(8):2712-2714
29. Козловская ЛВ, Гордовская НБ, Коротчаева ЮВ. Гломерулонефрит при HBV-, HCV-инфекциях, включая гломерулонефрит при криоглобулинемическом васкулите. В: Шилов ЕМ, Смирнов АВ, Козловская НЛ. Нефрология. ГЭОТАР-Медиа, М., 2016 [Kozlovskaia LV, Gordovskaia NB, Korotchaeva IUV. Glomerulonefrit pri HBV-, HCV-infektciiakh, vcliuchaia glomerulonefrit pri krioglobulinemicheskom vaskulite. V: Shilov EM, Smirnov AV, Kozlovskaia NL. Nefrologiia. GE`OTARMedia, M., 2016]
30. Leung N, Nasr S. Myeloma-related Kidney Disease. Advances in Chronic Kidney Disease 2014; 2(1): 36-41
31. Jhaveri KD. Shah HH, Patel C et al. Glomerular Diseases Associated With Cancer, Chemotherapy, and Hematopoietic Stem Cell Transplantation. Advances in Chronic Kidney Disease 2014; 21(1):48-55. doi.org/10.1053/j.ackd.2013.08.003
32. Kuppers R, Schwering I, Brauninger A et al. Biology of Hodgkin’s lymphoma. Ann Oncol 2002; 13 (suppl 1):11-18
33. Dabbs DJ, Striker LM, Mignon F et al. Glomerular lesions in lymphomas and leukemias. Am J Med 1986; 80:63–70
34. Rocca AR, Giannakakis C, Serriello I et al. Fludarabine in Chronic Lymphocytic Leukemia with Membranous Nephropathy. Renal Failure 2013; 35(2): 282–285
35. Shanafelt TD, Rabe KG, Hanson CA, et al. Renal disease in patients with chronic lymphocytic leukemia (CLL). Blood 2013;122 (21):abstr.
Review
For citations:
Anikonova L.I., Ryasnyanskiy V.U., Makarjyeva E.U., Vorobjyеva O.A. FOCAL SEGMENTAL GLOMERULOSCLEROSIS ASSOCIATED WITH CHRONIC LYMPHOCYTIC LEUKAEMIA: CASE REPORT AND LITERATURE REVIEW. Nephrology (Saint-Petersburg). 2016;20(6):101-110. (In Russ.)
Views:
3441
Email this article 