AIMS: The reported association of glomerular disease with chronic lymphocytic leukaemia (CLL) is rare despite the relative frequency of this type of leukaemia. Hence, we have examined the renal biopsies in three patients with CLL and glomerulonephritis. METHODS: Renal biopsies were examined by light microscopy, immunofluorescence microscopy and electron microscopy. RESULTS: One of two patients with mild impairment of renal function and an active urinary sediment had ultrastructural features of idiopathic type I membranoproliferative glomerulonephritis (MPGN), and the other had features of fibrillary/ immunotactoid glomerulonephritis with deposits of IgG and C3. One patient with nephrotic syndrome had characteristic electron microscopic appearances of type III MPGN. In all three there was an association with monoclonal gammopathy. The parameters of glomerular damage improved in association with response to drug treatment of the CLL. CONCLUSION: There is a spectrum of types of MPGN seen in patients with CLL and there appears to be an association with the presence of monoclonal gammopathy. This is the first reported case of type III MPGN in CLL.
AIMS: The reported association of glomerular disease with chronic lymphocytic leukaemia (CLL) is rare despite the relative frequency of this type of leukaemia. Hence, we have examined the renal biopsies in three patients with CLL and glomerulonephritis. METHODS: Renal biopsies were examined by light microscopy, immunofluorescence microscopy and electron microscopy. RESULTS: One of two patients with mild impairment of renal function and an active urinary sediment had ultrastructural features of idiopathic type I membranoproliferative glomerulonephritis (MPGN), and the other had features of fibrillary/ immunotactoid glomerulonephritis with deposits of IgG and C3. One patient with nephrotic syndrome had characteristic electron microscopic appearances of type III MPGN. In all three there was an association with monoclonal gammopathy. The parameters of glomerular damage improved in association with response to drug treatment of the CLL. CONCLUSION: There is a spectrum of types of MPGN seen in patients with CLL and there appears to be an association with the presence of monoclonal gammopathy. This is the first reported case of type III MPGN in CLL.
Authors: Ladan Zand; Andrea Kattah; Fernando C Fervenza; Richard J H Smith; Samih H Nasr; Yuzhou Zhang; Julie A Vrana; Nelson Leung; Lynn D Cornell; Sanjeev Sethi Journal: Am J Kidney Dis Date: 2013-04-26 Impact factor: 8.860
Authors: Januario E Castro; Julio A Diaz-Perez; Juan S Barajas-Gamboa; John M Horton; Noel Weidner; Thomas J Kipps Journal: Leuk Lymphoma Date: 2012-03-13
Authors: An S De Vriese; Sanjeev Sethi; Jens Van Praet; Karl A Nath; Fernando C Fervenza Journal: J Am Soc Nephrol Date: 2015-07-16 Impact factor: 10.121
Authors: Paolo Strati; Samih H Nasr; Nelson Leung; Curtis A Hanson; Kari G Chaffee; Susan M Schwager; Sara J Achenbach; Timothy G Call; Sameer A Parikh; Wei Ding; Neil E Kay; Tait D Shanafelt Journal: Haematologica Date: 2015-06-18 Impact factor: 9.941