A Case of Minimal Change Nephrotic Syndrome Secondary to Methotrexate-associated Hodgkin Lymphoma

Misa Iimori; Kazuhiro Sonomura; Yuichi Ueyama; Yuki Oobayashi; Hiroya Adachi; Mayuka Nakayama

doi:10.2169/internalmedicine.2572-23

Misa Iimori, Kazuhiro Sonomura, Yuichi Ueyama, Yuki Oobayashi, Hiroya Adachi, Mayuka Nakayama

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Keywords: minimal change nephrotic syndrome, methotrexate, Hodgkin lymphoma, T lymphocyte dysfunction, rheumatoid arthritis

JOURNAL OPEN ACCESS Advance online publication

Article ID: 2572-23

DOI https://doi.org/10.2169/internalmedicine.2572-23

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Abstract

The patient was a 64-year-old man who had been receiving methotrexate (MTX) for rheumatoid arthritis for 8 years. Computed tomography (CT) obtained one month prior to admission revealed numerous enlarged lymph nodes. Lower leg edema appeared two weeks prior to admission. Severe proteinuria was confirmed, and the patient was admitted. A renal biopsy revealed minimal changes in glomeruli. CT on day 14 revealed shrinking lymph nodes, and the patient was diagnosed with Hodgkin lymphoma by a neck lymph node biopsy. This is the first report of secondary minimal change nephrotic syndrome caused by an MTX-associated lymphoproliferative disorder.

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