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Focal segmental glomerulosclerosis associated with cutaneous and systemic plasmacytosis

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Abstract

Cutaneous and systemic plasmacytosis (CSP) is a rare lymphoproliferative disorder that mainly affects middle-aged Asian individuals. Although Castleman disease is often complicated with various renal involvements, glomerulonephritis associated with CSP, which is considered as a variant of Castleman disease, is rare. This report presents the case of a 41-year-old Japanese man with nephrotic syndrome associated with CSP. Renal biopsy findings showed focal segmental glomerulosclerosis (FSGS) and diffusely mild segmental mesangial proliferation. Plasma cell infiltration in the interstitium was not observed. Electron microscopic findings showed diffuse foot process effacement, localized involvement of subendothelial space widening with amorphous materials, and endothelial cell swelling. Lymph node biopsy findings denied Castleman disease. His skin regions and proteinuria were successfully treated with prednisolone and cyclosporine. The causal relationship between CSP and FSGS is unknown. However, increased serum levels of IL-6 and VEGF and decreased VEGF expression in the podocyte may contribute to renal lesions in patients with CSP. To our best knowledge, this is the first case of a patient with FSGS associated with CSP.

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Authors and Affiliations

  1. Internal Medicine 1, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan

    Shinsuke Isobe, Naro Ohashi, Naoko Katahashi, Sayaka Ishigaki, Takayuki Tsuji & Hideo Yasuda

  2. Blood Purification Unit, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan

    Naoko Tsuji & Akihiko Kato

  3. Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan

    Yoshihide Fujigaki

  4. Department of Pathology, Nihon University School of Medicine, Tokyo, Japan

    Akira Shimizu

Authors
  1. Shinsuke Isobe
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  2. Naro Ohashi
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  3. Naoko Katahashi
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  4. Sayaka Ishigaki
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  5. Naoko Tsuji
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  6. Takayuki Tsuji
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  7. Akihiko Kato
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  8. Yoshihide Fujigaki
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  9. Akira Shimizu
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  10. Hideo Yasuda
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Corresponding author

Correspondence to Shinsuke Isobe.

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All the authors have declared no competing interest.

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This article does not contain any studies with human participants performed by any of the authors.

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Written informed consent was obtained from the patient.

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Isobe, S., Ohashi, N., Katahashi, N. et al. Focal segmental glomerulosclerosis associated with cutaneous and systemic plasmacytosis. CEN Case Rep 6, 206–209 (2017). https://doi.org/10.1007/s13730-017-0276-z

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  • DOI: https://doi.org/10.1007/s13730-017-0276-z

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