Paraneoplastic glomerulopathy

Abstract

Paraneoplastic syndrome can be defined as a collection of signs and symptoms that are related to the presence of a tumor, but not directly attributable to mass effect or direct invasion. Paraneoplastic syndromes result from factors synthesized by the tumor or by the immune system in response to the tumor, including cytokines, hormones, tumor antigens, or antibodies. Paraneoplastic glomerulopathy is a term that refers to paraneoplastic syndromes that specifically involve the glomerulus. The topic of paraneoplastic glomerulopathy can be divided into (1) entities most commonly related to dysproteinemia and multiple myeloma, such as light chain amyloidosis and light chain deposition disease; (2) membranous glomerulopathy in the setting of solid organ tumors; and (3) a variety of less frequent associations of glomerular disease with carcinomas and hematolymphoid malignancies, including minimal change disease, IgA nephropathy, thrombotic microangiopathy, and amyloidosis.

Pathology spectrum of kidney damage in Hodgkin’s lymphoma, non-Hodgkin lymphoma/leukemia, and lymphoplasmacytic lymphoma in the real practice

“…MIgassociated types of damage are also well described in NHL/ CLL setting, and include immunotactoid GN, fibrillary GN, cryo-GN, AL amyloidosis, PGNMID, light chain deposition disease, and even ICMDD. [2][3][4][5][6][9][10][11][15][16][17][18][19][20] In our NHL/ CLL sub-group, we also found predominantly paraneoplastic GN, presenting with MPGN, MN, and MCD; with just few cases of MIg-related patterns (PGNMID and monotypic MN). It is worth noting that we also discovered AA amyloidosis in the patient with spine B-cell lymphoma, paraplegia, pelvic floor dysfunction, chronic urinary tract infection, multiple chronic bedsores, and severe NS.…”

“…The most common HL-associated kidney disease is MCD with NS; the second most reported kidney lesion historically considered is AA amyloidosis, however, more recently the number of such cases have decreased. 6,[8][9][10] FSGS and crescentic GN also found in some HL patients. 2,11 In our study, the incidence of NS was higher in the HL sub-group compared to NHL/CLL and LPL, even though the difference was not statistically significant.…”

“…Kidney pathology reveals various patterns of glomerulonephritis (GN), amyloidosis, specific lymphoid infiltration and other tubulointerstitial disorders, and thrombotic microangiopathy. [1][2][3][4][5][6] For this particular study, we focused on the clinical features and kidney pathology patterns in the patients with lymphomas, who underwent kidney biopsy in our center.…”

Acute kidney injury in Hodgkin’s lymphoma, non-Hodgkin lymphoma/leukemia, and lymphoplasmacytic lymphoma: One center experience

“…We consider PGNMID, AL amyloidosis, MPGN, MN, FSGS, and IgAN, which totally presented in 13 cases, as NHL/CLL-related and HL-related causes of the underlying CKD, as all these variants of kidney damage were described in the NHL/CLL and HL setting. 3,6,16,[22][23][24][25][26][27][28][29] PGNMID and AL resulted from direct paraprotein deposition, while MPGN, MN, FSGS, and IgAN represent paraneoplastic spectrum. 24,25 AKI on the top of CKD in these 13 patients was pre-renal (9 cases), caused by LI (3 cases) and TLS (1 case).…”

“…3,6,16,[22][23][24][25][26][27][28][29] PGNMID and AL resulted from direct paraprotein deposition, while MPGN, MN, FSGS, and IgAN represent paraneoplastic spectrum. 24,25 AKI on the top of CKD in these 13 patients was pre-renal (9 cases), caused by LI (3 cases) and TLS (1 case). We considered both cases of AA amyloidosis as indirectly related to HL and NHL, as they were associated with chronic infectious treatment complications.…”