Renal biopsy cases in myeloproliferative neoplasms (MPN)

Abstract

We performed renal biopsy in three cases complicated by myeloproliferative neoplasms (MPN). Although several cases of glomerulonephritis associated with MPN have been reported, the etiologies of the renal disorders were not established (Plomley et al., Aust NZ J Med, 13:125–129, 1983; Sharma et al., Nephron, 69:361, 1995; Kanauchi et al., Intern Med, 33:36–40, 1994; Kasuno et al., Nephrol Dial Transplant, 12:212–215, 1997; Au et al., Am J Kid Dis, 34:889–893, 1999; Kosch et al., Nephrol Dial Transplant, 15:1710–1711, 2000; Oymak et al., Nephron, 86:346–347, 2000; Chun et al., Am J Nephrol, 20:344–346, 2000; Chung et al., Am J Nephrol, 22:397–401, 2002; Asaba et al., Clin Exp Nephrol, 7:296–300, 2003; Haraguchi et al., Clin Exp Nephrol, 10:74–77, 2006; Saigusa et al., J Nephrol, 19:656–658, 2006; Okuyama et al., Clin Nephrol, 6:412–415, 2007; Nishi et al., Clin Nephrol, 5:393–398, 2010; Ulusoy et al., Intern Med, 49:2477, 2010). A review of previous reports of renal biopsy cases with MPN in the English literature suggested that circulation control is important for the treatment of renal disorders that mimic glomerulonephritis in MPN.

Renal disease associated with myeloproliferative neoplasms and myelodysplastic syndrome/myeloproliferative neoplasms

“…33 Remarkably, many patients (41%) showed IgAN or IR-like GN (Table 2). Although some IgAN cases have been reported previously, 9,14 our data indicate, for the first time, that there might be a link between MPN-associated or MDS/MPN-associated renal disease and GN with C3 deposition, reminiscent of infectionrelated GN. This observation could possibly point to activation of the complement system due to secreted soluble factors, or possibly a subtype of C3 GN developing in the context of myeloid disease.…”

“…Kidney failure and proteinuria have been reported previously in MPN patients [7][8][9]14 (Table 1). Our cohort represents a systematic, and so far the largest, collection of patients with a history of MPNs or MDS/ MPNs in whom a renal biopsy was performed.…”

“…7,8 Some of these features were also described in subsequent reports. [9][10][11][12][13][14] However, owing to the selection bias of case reports focusing on particularly interesting cases, the morphological spectrum and frequency of renal biopsy findings are difficult to estimate. For MDS/MPN patients, no such data are available.…”

“…The two largest cohorts published so far showed features of chronic thrombotic microangiopathy (TMA), glomerulosclerosis, and intracapillary haematopoiesis 7,8 . Some of these features were also described in subsequent reports 9–14 . However, owing to the selection bias of case reports focusing on particularly interesting cases, the morphological spectrum and frequency of renal biopsy findings are difficult to estimate.…”

Immune Complex Associated Glomerulonephritis in a Patient with Prefibrotic Primary Myelofibrosis: A Case Report

“…IgA nephropathy has been reported previously in cases of PV and ET. [ 9 10 ] IgA being the dominant immunoglobulin on DIF in the present case, a possible diagnosis of IgA nephropathy was considered. However, IgA nephropathy was precluded based on significant C1q deposition, which is uncommon in IgA nephropathy.…”