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Minimal change nephrotic syndrome associated with non-Hodgkin lymphoid disorders:
a retrospective study of 18 cases
#MMPMID25500704
Kofman T
; Zhang SY
; Copie-Bergman C
; Moktefi A
; Raimbourg Q
; Francois H
; Karras A
; Plaisier E
; Painchart B
; Favre G
; Bertrand D
; Gyan E
; Souid M
; Roos-Weil D
; Desvaux D
; Grimbert P
; Haioun C
; Lang P
; Sahali D
; Audard V
Medicine (Baltimore)
2014[Nov]; 93
(24
): 350-358
PMID25500704
show ga
Few studies have examined the occurrence of minimal change nephrotic syndrome
(MCNS) in patients with non-Hodgkin lymphoma (NHL). We report here a series of 18
patients with MCNS occurring among 13,992 new cases of NHL. We analyzed the
clinical and pathologic characteristics of this association, along with the
response of patients to treatment, to determine if this association relies on a
particular disorder. The most frequent NHLs associated with MCNS were Waldenström
macroglobulinemia (33.3%), marginal zone B-cell lymphoma (27.8%), and chronic
lymphocytic leukemia (22.2%). Other lymphoproliferative disorders included
multiple myeloma, mantle cell lymphoma, and peripheral T-cell lymphoma. In 4
patients MCNS occurred before NHL (mean delay, 15 mo), in 10 patients the
disorders occurred simultaneously, and in 4 patients MCNS was diagnosed after NHL
(mean delay, 25 mo). Circulating monoclonal immunoglobulins were present in 11
patients. A nontumoral interstitial infiltrate was present in renal biopsy
specimens from 3 patients without significant renal impairment. Acute kidney
injury resulting from tubular lesions or renal hypoperfusion was present in 6
patients. MCNS relapse occurred more frequently in patients treated exclusively
by steroid therapy (77.8%) than in those receiving steroids associated with
chemotherapy (25%). In conclusion, MCNS occurs preferentially in NHL originating
from B cells and requires an aggressive therapeutic approach to reduce the risk
of MCNS relapse.
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