Abstract
Waldenström’s macroglobulinemia is rare lymphoproliferative disorder characterized by the presence of a monoclonal IgM paraproteinemia. Cryoglobulinemia is a common sequela of Waldenström’s macroglobulinemia present in 8–18% of the patients. Cryoglobulinemia has also been described as occurring after treatment with rituximab. In the previous report, the cryoglobulinemia was a transient phenomenon and did not carry any adverse effect. We present a case of an 80-year-old male with Waldenström’s macroglobulinemia in whom the rituximab-induced cryoglobulinemia resulted in acute renal failure and a vasculitic rash. Cryoglobulins level reached a peak of 63%. The patient was successfully treated with plasmapheresis, chlorambucil and prednisone, with near-complete recovery of renal function. As this case illustrates, the rituximab-induced cryoglobulin is not always benign. Pre- and post-treatment monitoring of the cryoglobulin level is advised in these patients.
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Shaikh, A., Habermann, T.M., Fidler, M.E. et al. Acute renal failure secondary to severe type I cryoglobulinemia following rituximab therapy for Waldenström’s macroglobulinemia. Clin Exp Nephrol 12, 292–295 (2008). https://doi.org/10.1007/s10157-008-0042-9
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DOI: https://doi.org/10.1007/s10157-008-0042-9