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Disorders of Leukocytes

Disorders of Leukocytes

Leukocyte disorders can lead to either leukopenia, characterized by an abnormally low leukocyte count, or leukocytosis, marked by a very high leukocyte number.
Leukopenia may result from bone marrow disorders, autoimmune diseases, and infectious diseases. For example, conditions such as multiple myeloma and aplastic anemia can impair the bone marrow's ability to produce adequate leukocytes. Similarly, autoimmune diseases like lupus and viral infections such as HIV can prompt the immune...

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Lambda Light Chain Cast Nephropathy Caused by Splenic Marginal Zone Lymphoma.

Joyce H Gu¹, Nicholas Smothermon², Jusnimrat Kohli²

¹Medicine, Lake Erie College of Osteopathic Medicine, Greensburg, USA.

|January 20, 2025

Summary

This case study details a patient with splenic marginal zone lymphoma who developed kidney injury due to light chain cast nephropathy. This rare complication highlights a serious risk associated with certain lymphomas.

Keywords:

cast nephropathy lambda light chain light cast chain nephropathy marginal zone lymphoma mzl splenic marginal zone lymphoma

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Area of Science:

Hematology
Nephrology
Oncology

Background:

Splenic marginal zone lymphoma (SMZL) is a rare B-cell lymphoma.
Monoclonal gammopathy can indicate underlying plasma cell disorders or lymphoproliferative diseases.
Renal injury in lymphoma patients can stem from various mechanisms, including direct infiltration or paraneoplastic syndromes.

Observation:

An elderly male patient presented with symptoms of renal injury.
Diagnostic workup revealed monoclonal gammopathy with elevated free lambda light chains.
Bone marrow biopsy excluded multiple myeloma, while renal biopsy confirmed lambda light chain cast nephropathy.

Findings:

The patient had splenic marginal zone lymphoma with monoclonal CD5+ B cells.
Lambda light chain cast nephropathy was identified as the cause of renal failure.
Despite interventions, the patient's condition worsened, leading to expiration.

Implications:

This case underscores light chain cast nephropathy as a critical and rare complication of lymphomas.
It emphasizes the importance of considering renal pathology in lymphoma patients with declining kidney function.
Early recognition and management of light chain nephropathy may improve outcomes in lymphoma patients.