Abstract
Purpose
Cryoglobulinemia is a pathological condition characterized by the presence of cryoglobulins in the blood, with cryoglobulinemic glomerulonephritis being the most frequent form of renal involvement. Fanconi syndrome presents as a generalized dysfunction of the proximal tubule, characterized by the presence of polyuria, phosphaturia, glycosuria, proteinuria, proximal renal tubular acidosis, and osteomalacia. We aimed to present five cases co-occurring with Fanconi syndrome and cryoglobulinemia.
Methods
We retrospectively summarized the cases of five patients with Fanconi syndrome and cryoglobulinemia at Peking Union Medical College Hospital from January 2012 to June 2022. The clinical features, diagnosis, treatment, and prognosis were systematically analyzed.
Results
All five patients exhibited typical features of Fanconi syndrome, and cryoglobulinemia was concurrently detected in all cases. These patients also exhibit positive anti-nuclear antibody spectrum and hyperglobulinemia, and IgM constitutes the predominant monoclonal component in cryoglobulins. In addition to supplemental treatment, timely immunosuppressive therapy may potentially benefit the long-term renal prognosis of patients with this condition.
Conclusion
Our findings highlight the rare co-occurrence of Fanconi syndrome and cryoglobulinemia in clinical practice. Despite the lack of causal evidence, the coexistence of Fanconi syndrome and tubulointerstitial injury is also noteworthy in patients with cryoglobulinemia, underscoring the importance of thorough evaluation and tailored management in patients presenting with overlapping renal manifestations.
Key Points • Patients with mixed cryoglobulinemia can clinically present with tubulointerstitial injury, specifically manifesting as Fanconi syndrome. • In addition to typical symptoms of Fanconi syndrome, these patients also exhibit positive anti-nuclear antibody spectrum and hyperglobulinemia, while IgM constitutes the monoclonal component in cryoglobulins. • Timely immunosuppressive therapy may improve long-term renal prognosis in these patients. |
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All necessary data have been presented as tables and figures in the manuscript. Related information is accessible to the corresponding author upon request.
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Funding
This work was supported by the National High Level Hospital Clinical Research Funding under Grant [2022-PUMCH-B-020] (Y.Q), Sansheng Yeehong TCP Research Foundation (G.C), Bethune Charitable Foundation under Grant [J202103E006] (G.C.), and the Peking Union Scholars and Innovation Team Development Programme (2016) (X.L.).
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This study was approved by the Institutional Review Board of PUMCH and was performed in accordance with the ethical standards established by the 1964 Declaration of Helsinki and its later amendments.
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Xu, Q., Chen, G., Wen, Y. et al. Acquired Fanconi syndrome in mixed cryoglobulinemia patients: a single-center case series. Clin Rheumatol (2024). https://doi.org/10.1007/s10067-024-06997-2
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DOI: https://doi.org/10.1007/s10067-024-06997-2