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Nephrotic syndrome without kidney injury revealing intravascular large B cell lymphoma

Lucie Pothen1, Selda Aydin2, Alessandra Camboni2

  • 1Service de Médecine interne et Maladies Infectieuses, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.

BMJ Case Reports
|June 15, 2019
PubMed

Insights

This case study details a woman with fever of unknown origin who developed nephrotic syndrome and pulmonary infiltrates. Intracapillary glomerular invasion by intravascular large B cell lymphoma was diagnosed and successfully treated with R-CHOP and stem cell transplant.

Area of Science:

  • Nephrology
  • Hematology
  • Oncology

Background:

  • Intravascular large B cell lymphoma (ILBCL) is a rare non-Hodgkin lymphoma.
  • ILBCL can present with diverse clinical manifestations, including renal involvement.

Observation:

  • A 64-year-old woman presented with fever of unknown origin.
  • During hospitalization, she developed nephrotic syndrome and pulmonary infiltrates.
  • Renal biopsy revealed intracapillary glomerular invasion by ILBCL.

Findings:

  • The patient received treatment with rituximab, cyclophosphamide, doxorubicine, vincristine, and prednisone (R-CHOP) chemotherapy.
  • Autologous stem cell transplant was performed following chemotherapy.
  • Clinical and biological parameters improved significantly after treatment.

Implications:

  • This case highlights the importance of considering ILBCL in the differential diagnosis of nephrotic syndrome with pulmonary involvement.
  • Successful treatment of renal ILBCL with R-CHOP and stem cell transplant is demonstrated.
  • Early diagnosis and aggressive treatment can lead to favorable outcomes in rare lymphoma presentations.

Keywords:
haematology (incl blood transfusion)nephrotic syndrome

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