Continuous hypergammaglobulinemia and proteinuria after the recovery of the visceral Leishmaniasis: a case report

Abstract

Background Kidney involvement of visceral Leishmaniasis is previously reported, but knowledge is limited. Hypergammaglobulinemia is common in visceral leishmaniasis patients. Whether hypergammaglobulinemia after leishmaniasis depletion can cause kidney injury is not well reported yet. Case presentation We reported a patient who recovered from visceral Leishmaniasis but showed persistent hypergammaglobulinemia and elevated urinary protein. Kidney biopsy showed glomerular hypertrophy with mild segmental mesangial proliferation without tubulointerstitial involvement in light microscopy. No immune complex deposit was found in the mesangial area by neither immunofluorescent staining nor electronic microscope. Increased lysosomes were observed in proximal tubules by electronic microscope. Valsartan was administered to decrease urinary protein, and no immune-suppressive therapy was added. The urinary protein and serum IgG level gradually dropped, and serum creatinine level remained stable during three- month follow up. Conclusions Hypergammaglobulinemia is unlikely to cause renal structural or functional damage in the short term. Angiotensin blockade significantly reduced urine protein, with a minor effect on IgG elimination.

Clinical Study of Rituximab Combined with Chemotherapy in the Treatment of Lymphoma with Hypergammaglobulinemia

“…There are only a few studies on hypoimmunoglobulinemia in lymphoproliferative diseases. In the study of lymphoproliferative diseases with hypergammaglobulinemia, most of them are reported as individual case [2][3][4] and the number of cases is limited, mainly including hemangioimmunoblastic lymphoma and chronic lymphocytic leukemia [5] . There is no related study on lymphoma complicated with hypergamma globulinemia.…”