Type II Cryoglobulinemic Membranoproliferative Glomerulonephritis Caused by Mucosa-associated Lymphoid Tissue Lymphoma

Ayano Sugihara; Hiroshi Ureshino; Masatora Yamasaki; Makoto Fukuda; Maki Yoshihara; Eriko Nonaka; Mariko Miyazaki; Mai Fujita; Keitaro Ishii; Kazuharu Kamachi; Haruhiko Sano; Sho Okamoto; Hidekazu Itamura; Mariko Yoshimura; Hiroo Katsuya; Toshihiko Ando; Shigehisa Aoki; Yoshifumi Ubara; Shinya Kimura

doi:10.2169/internalmedicine.0756-22

CASE REPORTS

Type II Cryoglobulinemic Membranoproliferative Glomerulonephritis Caused by Mucosa-associated Lymphoid Tissue Lymphoma

Ayano Sugihara, Hiroshi Ureshino, Masatora Yamasaki, Makoto Fukuda, Maki Yoshihara, Eriko Nonaka, Mariko Miyazaki, Mai Fujita, Keitaro Ishii, Kazuharu Kamachi, Haruhiko Sano, Sho Okamoto, Hidekazu Itamura, Mariko Yoshimura, Hiroo Katsuya, Toshihiko Ando, Shigehisa Aoki, Yoshifumi Ubara, Shinya Kimura

Author information

Ayano Sugihara
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Hiroshi Ureshino
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Japan
Masatora Yamasaki
Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Makoto Fukuda
Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Maki Yoshihara
Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Eriko Nonaka
Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Mariko Miyazaki
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Mai Fujita
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Keitaro Ishii
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Kazuharu Kamachi
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Haruhiko Sano
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Sho Okamoto
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Hidekazu Itamura
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Mariko Yoshimura
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Hiroo Katsuya
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Toshihiko Ando
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
Shigehisa Aoki
Division of Pathology, Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Japan
Yoshifumi Ubara
Nephrology Center, Toranomon Hospital, Japan
Shinya Kimura
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan

Keywords: type II cryoglobulinemic vasculitis, membranoproliferative glomerulonephritis, mucosa-associated lymphoid tissue lymphoma, rituximab, bendamustine

JOURNAL OPEN ACCESS
Supplementary material

2023 Volume 62 Issue 13 Pages 1983-1988

DOI https://doi.org/10.2169/internalmedicine.0756-22

Details

Abstract

A 67-year-old man complained of lower limb edema with a purpuric skin rash. Laboratory tests revealed proteinuria, elevated serum creatinine levels, and low serum albumin levels. The patient was also positive for cryoglobulin in serum, immunoglobulin (Ig) M gammopathy, hypocomplementemia, and rheumatoid factor. He was negative for anti-hepatitis C virus antibodies. A pathological analysis of the renal tissue revealed membranoproliferative glomerulonephritis, common histological features of cryoglobulinemic vasculitis (CV), and mucosa-associated lymphoid tissue lymphoma invasion. Although hematologic malignancy is a rare cause of type II CV, these clinical findings suggest that mucosa-associated lymphoid tissue lymphoma (MALT) lymphoma may have been the cause in the present case.

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