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Mantle cell lymphoma first presenting as immune complex-mediated glomerulonephritis: a case report
Rajitha Asanga Abeysekera1, Abdul Wahid Mohomad Wazil2, Nishantha Nanayakkara3
1Nephrology and Transplantation Unit, Teaching Hospital, Kandy, Sri Lanka. rajithaasa55@gmail.com.
Journal of Medical Case Reports
|May 20, 2015
Summary
Mantle cell lymphoma, a rare non-Hodgkin lymphoma, can initially present as immune complex glomerulonephritis. Early suspicion in such cases aids in timely diagnosis and treatment of this B-cell lymphoma.
Area of Science:
- Nephrology
- Hematology
- Oncology
Background:
- Kidney involvement is a known complication of non-Hodgkin lymphoma, but typically diagnosed after the lymphoma is identified.
- Mantle cell lymphoma (MCL) is a type of B-cell non-Hodgkin lymphoma.
Observation:
- A 58-year-old man presented with gross hematuria, bicytopenia, splenomegaly, and elevated creatinine.
- Renal biopsy showed acute immune complex glomerulonephritis with interstitial inflammation.
- Initial bone marrow and blood imaging were inconclusive.
Findings:
- A lymph node biopsy three months later confirmed mantle cell lymphoma.
- Chemotherapy led to normalization of renal function within three months, sustained at one year.
Implications:
- Acute immune complex glomerulonephritis without a clear cause warrants suspicion for underlying non-Hodgkin lymphoma.
- This case highlights MCL as a potential initial presentation of non-Hodgkin lymphoma.
- Prompt diagnosis and treatment of the underlying lymphoma can lead to recovery of renal function.
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