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Long-term clinical course of immunotactoid glomerulopathy complicated with diffuse large B-cell lymphoma

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Abstract

We report a case of immunotactoid glomerulopathy (ITG) complicated with diffuse large B-cell lymphoma (DLBCL). A 68-year-old woman presented with leg edema and was diagnosed with nephrotic syndrome (NS). Renal biopsy revealed ITG. We treated the patient with prednisolone (20 mg/day) and she achieved complete remission of NS. Steroids were gradually reduced. After 1 year, the patient presented with a breast mass determined on biopsy to be DLBCL. She underwent six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) therapy. Follow-up revealed complete remission of both DLBCL and ITG. NS recurred after 5 years and she was simultaneously diagnosed with recurrence of DLBCL in bone marrow. She underwent four cycles of R-EPOCH (rituximab, etoposide, prednisolone, vincristine, cyclophosphamide, doxorubicin) therapy and entered remission for DLBCL. NS improved, but the treatment did not lead to remission. After 2 additional years, NS and DLBCL recurred again. She was administered rituximab and NS improved, although proteinuria tended to increase thereafter. One year later, we started prednisolone (10 mg/day), and proteinuria tended to decrease. She is currently undergoing outpatient follow-up. This case suggests that ITG with MGUS should be treated with the possibility of developing malignant hematological disease during the course.

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Acknowledgements

We thank Richard Robins, PhD, from Edanz Group (https://en-author-services.edanzgroup.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Nephrology, Kitasato University School of Medicine, Sagamihara, Japan

    Haruka Takahashi, Takashi Sano, Sayumi Kawamura, Keiko Sano, Ryoma Miyasaka, Takuya Yamazaki, Mayuko Sakakibara, Tetsuya Abe, Keiko Hashimoto, Miki Nagaoka, Mariko Kamata, Shokichi Naito, Togo Aoyama, Rika Moriya & Yasuo Takeuchi

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  1. Haruka Takahashi
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  2. Takashi Sano
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  3. Sayumi Kawamura
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Correspondence to Haruka Takahashi.

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Takahashi, H., Sano, T., Kawamura, S. et al. Long-term clinical course of immunotactoid glomerulopathy complicated with diffuse large B-cell lymphoma. CEN Case Rep 11, 184–190 (2022). https://doi.org/10.1007/s13730-021-00648-0

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  • DOI: https://doi.org/10.1007/s13730-021-00648-0

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