Membranoproliferative Glomerulonephritis Associated with Multicentric Angiofollicular Lymph Node Hyperplasia

Abstract

A 14-year-old boy presented with fever, anemia, hepatosplenomegaly, generalized lymphadenopathy and nephrotic syndrome. Lymph node biopsy showed angiofollicular lymph node hyperplasia (generalized Castleman’s disease) of the plasma cell type. Kidney biopsy showed membranoproliferative glomerulonephritis type 1. Complete remission was achieved with corticosteroid treatment and repeat kidney biopsy 22 months later showed complete resolution of the renal pathology. The association between membranoproliferative glomerulonephritis and multicentric angiofollicular lymph node hyperplasia, plasma cell type, has not previously been reported.

Membranoproliferative Glomerulonephritis in Castleman's Disease: A Systematic Review of the Literature and 2 Case Reports

“…Most patients have been treated with alternative pharmacotherapies such as interferon-alpha (IFN-a), thalidomide, rituximab, bortezomib, anti-IL-6 receptor antibodies, corti-costeroids and chemotherapy, per different etiology and pathogenesis of CD. When the therapies of the 6 previously reported cases were compared (Table 2), Three used corticosteroids as a single-agent therapy (2,4,6). In one special case, combination therapy replaced single steroid therapy halfway due to disease recurrence (5).…”

“…Because CD with renal complications is easily clinically misdiagnosed or ignored, nephrologists must remain vigilant. There have been only reports of seven MPGN/ MPGN-like cases associated with CD, among which six reports were in the English language and indexed by the PubMed database (2)(3)(4)(5)(6)(7). Together with the relevant literature review, we herein report 2 cases of MPGN lesion in multicentric type CD (MCD): one is MPGN of hyaline vascular variant (HVV) and the other is MPGN of mixed variant.…”

Fracaso renal agudo por microangiopatía trombótica asociado a enfermedad de Castleman

“…La afectación renal no es infrecuente, habiéndose descrito casos de glomerulonefritis membranosa (18), amiloido-sis (19,20), nefritis intersticial (21) glomerulonefritis proliferativa mesangial (22), glomerulonefritis membrano-proliferativa (23)(24)(25), glomerulonefritis rápidamente progresiva (26), enfermedad por cambios mínimos (27), glomerulonefritis fibrilar (27), o fallo renal agudo secundario a microangiopatía trombótica (19,29,30).…”

Successful Treatment of a Mesangial Proliferative Glomerulonephritis with Interstitial Nephritis Associated with Castleman's Disease by an Anti-interleukin-6 Receptor Antibody (Tocilizumab)

“…MCD is usually associated with plasma cell type and mixed type (2). Renal complications are uncommon in MCD; however, they show various lesions including minimal change disease, membranous nephropathy, membranoproliferative glomerulonephritis, mesangial proliferative glomerulonephritis, thrombotic microangiopathy, interstitial nephritis and amyloidosis (3)(4)(5)(6)(7). Excess IL-6 production by hyperplastic lymph nodes is thought to play a central role in the pathogenesis of MCD and manifestations including renal complications (8).…”