Chronic lymphocytic leukemia-associated membranous glomerulopathy: remission with fludarabine

In some individuals, chronic lymphocytic leukemia (CLL) may be associated with glomerular disease from membranous nephropathy with resultant nephrotic syndrome. CLL is characterized by abnormal immunoregulation with a malignant clonal proliferation of lymphocytes. The association between the abnormal clone and nephrotic syndrome is suggested in some cases by the remission of proteinuria with a reduction in abnormal lymphocyte number after treatment with antineoplastic agents. For the first time, we describe a patient with CLL and associated membranous glomerulopathy whose nephrotic syndrome remitted after treatment with fludarabine, a new purine analogue used in the treatment of refractory CLL.