Renal Thrombotic Microangiopathy Associated with Multicentric Castlemanʼs Disease

Lajoie, Ginette; Kumar, Satish; Min, Kyung-Whan; Silva, Fred G.

doi:10.1097/00000478-199509000-00005

Cited by 21 publications

(8 citation statements)

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“…The additional presence in our case of autoimmune haemolytic anaemia and autoimmune thrombocytopenia suggests a more generalised immunological disturbance in multicentric Castleman's disease, which is supported by the following observations: (1) the detection of various types of autoantibodies in previously reported cases of Castleman's disease—associated or not with renal manifestations—like antiplatelet or anticardiolipin autoantibodies;8 11 (2) the recently described case of an anti-GBM glomerulonephritis in a Castleman's disease patient10 and the detection of anti-MPO antibodies in a previously reported case of crescentic glomerulonephritis seen in another Castleman's disease patient;9 and (3) the identification of a secreted autoantibody in cultured Castleman's tumour cells which reacts against epidermal proteins, in paraneoplastic pemphigus, a serious autoimmune skin disorder, seen in Castleman's disease 12…”

Section: Discussionsupporting

confidence: 87%

Membranoproliferative glomerulonephritis in the setting of multicentric angiofollicular lymph node hyperplasia (Castleman's disease) complicated by Evan's syndrome

et al. 2010

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Systemic Castleman's disease is a lymphoproliferative disorder with various clinical presentations and incompletely understood aetiology. The authors report on a rare case of the plasma cell variant of Castleman's disease associated with autoimmune haemolytic anaemia and autoimmune thrombocytopenia (Evan's syndrome) and complicated by mixed nephrotic–nephritic syndrome and acute renal failure due to an underlying glomerulopathy with microscopic and immunofluorescence findings suggestive of membranoproliferative glomerulonephritis (MPGN) type I. Immunocomplexed glomerulonephritis is rare in Castleman's disease, while, to the best of our knowledge, constellation of all these autoimmune phenomena is reported for the first time suggesting that apart from the putative role of VEGF and IL-6 in the pathogenesis of the disease, a more generalised immunological disturbance occurs, probably through autoantibodies induced by active polyclonal B cells raised from Castleman's disease tumour.

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Section: Discussionsupporting

confidence: 87%

Membranoproliferative glomerulonephritis in the setting of multicentric angiofollicular lymph node hyperplasia (Castleman's disease) complicated by Evan's syndrome

et al. 2010

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“…In addition, one patient 35 had multicentric Castleman's disease, and the necropsy of another patient disclosed a carcinoma of the uterus with pleural, bone, and hepatic metastasis. 41 Clinical presentation and precipitating factors In 26 (57%) patients, TMHA was the first clinical manifestation of APS, whereas a total of seven (15%) patients had a previous history of major vascular occlusions. Deep venous thrombosis was reported as occurring in four (9%) patients, and in one this was accompanied by pulmonary embolism.…”

Section: Resultsmentioning

confidence: 99%

Thrombotic microangiopathic haemolytic anaemia and antiphospholipid antibodies

Espinosa

Bucciarelli²,

Cervera³

et al. 2004

Annals of the Rheumatic Diseases

143

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Objective: To analyse the clinical and laboratory features of patients with thrombotic microangiopathic haemolytic anaemia (TMHA) associated with antiphospholipid antibodies (aPL). Methods: A computer assisted (PubMed) search of the literature was performed to identify all cases of TMHA associated with aPL from 1983 to December 2002. Results: 46 patients (36 female) with a mean (SD) age at presentation of TMHA of 34 (15) years were reviewed. Twenty eight (61%) patients had primary antiphospholipid syndrome (APS). TMHA was the first clinical manifestation of APS in 26 (57%) patients. The clinical presentations were haemolytic-uraemic syndrome (26%), catastrophic APS (23%), acute renal failure (15%), malignant hypertension (13%), thrombotic thrombocytopenic purpura (13%), and HELLP (haemolysis, elevated liver enzymes, and low platelet count in association with eclampsia) syndrome (4%). Lupus anticoagulant was detected in 86% of the episodes of TMHA, and positive anticardiolipin antibodies titres in 89%. Steroids were the most common treatment (69% of episodes), followed by plasma exchange (PE) (62%), anticoagulant or antithrombotic agents (48%), immunosuppressive agents (29%), and immunoglobulins (12%). Recovery occurred in only 10/29 (34%) episodes treated with steroids, and in 19/27 (70%) episodes treated with PE. Death occurred in 10/46 (22%) patients. Conclusions:The results emphasise the need for systematic screening for aPL in all patients with clinical and laboratory features of TMHA. The existence of TMHA in association with an APS forces one to rule out the presence of the catastrophic variant of this syndrome. PE is indicated as a first line of treatment for all patients with TMHA associated with aPL.

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“…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).…”

Section: Discussionunclassified

Fracaso renal agudo por microangiopatía trombótica asociado a enfermedad de Castleman

Montes

Mompeán

Villaescusa

et al. 2007

An. Med. Interna (Madrid)

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Renal Thrombotic Microangiopathy Associated with Multicentric Castlemanʼs Disease

Cited by 21 publications

References 0 publications

Membranoproliferative glomerulonephritis in the setting of multicentric angiofollicular lymph node hyperplasia (Castleman's disease) complicated by Evan's syndrome

Membranoproliferative glomerulonephritis in the setting of multicentric angiofollicular lymph node hyperplasia (Castleman's disease) complicated by Evan's syndrome

Thrombotic microangiopathic haemolytic anaemia and antiphospholipid antibodies

Fracaso renal agudo por microangiopatía trombótica asociado a enfermedad de Castleman

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