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dc.contributor.authorThet, Z
dc.contributor.authorHan, T
dc.contributor.authorHan, C
dc.contributor.authorJama, D
dc.contributor.authorWin, M
dc.description.abstractBackground Extramedullary/extranodal manifestations of chronic lymphocytic leukemia(CLL) are rare and they can occur with or without the presence of systemic CLL. Renal biopsies are rarely performed in patients with CLL and little is known about the mechanisms causing renal pathology in CLL. There is no standard of care in such patients. Case Report A 78 year old female was diagnosed with Binet Stage B CLL with trisomy 21 and IgM paraproteinaemia more than a decade ago. She had been on watchful waiting without any treatment for her CLL. In 2016, her eGFR declined gradually to 26 mL/min/1.73 m2. Urine examination showed microscopic glomerular haematuria and proteinuria (8 g/day). Renal ultrasound, complement results, screening tests for infections, autoimmune diseases and cryoglobulinemia were normal. Renal Biopsy showed acute membranoproliferative glomerulonephritis (MPGN) with mixed lymphocytic infiltrate of aberrant B cells and reactive lymphocytes with no cytological atypia. There is clumpy focal staining for IgG, IgM, C3, C1q and light chains (lambda>kappa) in the glomeruli. The RCVP (Rituximab, Cyclophosphamide, Vincristine, Prednisolone) chemotherapy regimen was given for 6 cycles with omission of Vincristine in the last 2 cycles. Restaging marrow post treatment showed good partial response. Subsequently, her renal function was normalised to baseline (eGFR 62 mL/min/1.73 m2) with resolution of proteinuria. Bone marrow examination repeated 2 months after her chemotherapy showed good partial response. Conclusion Deposition of monoclonal immunoglobulins especially IgM secreted by leukemia B cells may cause MPGN. Kidney biopsy can provide important information for diagnosis and therapeutic guidance. Renal dysfunction due to CLL can be reversed by treating the underlying CLL.
dc.relation.ispartofconferencename54th Annual Scientific Meeting of the Australian and New Zealand Society of Nephrology (ANZSN)
dc.relation.ispartoflocationSydney, Australia
dc.subject.fieldofresearchClinical sciences
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsUrology & Nephrology
dc.titleA case of membranoproliferative glomerulonephritis in chronic lymphocytic leukemia
dc.typeConference output
dc.type.descriptionE3 - Conferences (Extract Paper)
dcterms.bibliographicCitationThet, Z; Han, T; Han, C; Jama, D; Win, M, A case of membranoproliferative glomerulonephritis in chronic lymphocytic leukemia, Nephrology, 2018, 23, pp. 80-80
gro.hasfulltextNo Full Text
gro.griffith.authorThet, Zaw

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