Membranous nephropathy with systemic light-chain amyloidosis of remission after rituximab therapy: A case report

BACKGROUND: About 70%-80% of patients with primary membranous nephropathy (MN) have phospholipase A2 receptor (PLA2R) in renal tissue. Systemic light-chain (AL) amyloidosis is the most common type of amyloidosis. MN complicated with amyloidosis is rare. CASE SUMMARY: A 48-year-old Chinese male prese...

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Autores principales: Zhang, Jiao, Wang, Xu, Zou, Gu-Ming, Li, Jia-Yi, Li, Wen-Ge
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2023
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10450367/
https://www.ncbi.nlm.nih.gov/pubmed/37637680
http://dx.doi.org/10.12998/wjcc.v11.i23.5538
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author Zhang, Jiao
Wang, Xu
Zou, Gu-Ming
Li, Jia-Yi
Li, Wen-Ge
author_facet Zhang, Jiao
Wang, Xu
Zou, Gu-Ming
Li, Jia-Yi
Li, Wen-Ge
author_sort Zhang, Jiao
collection PubMed
description BACKGROUND: About 70%-80% of patients with primary membranous nephropathy (MN) have phospholipase A2 receptor (PLA2R) in renal tissue. Systemic light-chain (AL) amyloidosis is the most common type of amyloidosis. MN complicated with amyloidosis is rare. CASE SUMMARY: A 48-year-old Chinese male presented with nephrotic syndrome, positive serum PLA2R antibody, and positive serum and urine IgG-lambda type M-protein, with a normal ratio of serum-free light-chain level. The patient was diagnosed with MN accompanied by AL amyloidosis. He was treated with rituximab with glucocorticoids and CyBorD regimen of chemotherapy. After 21 mo of follow-up, the patient achieved complete remission regarding nephrotic syndrome without adverse effects of chemotherapy. CONCLUSION: We report a case of PLA2R-related MN complicated with primary AL amyloidosis only with renal involvement and successfully treated with rituximab, glucocorticoids and chemotherapy.
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spelling pubmed-104503672023-08-26 Membranous nephropathy with systemic light-chain amyloidosis of remission after rituximab therapy: A case report Zhang, Jiao Wang, Xu Zou, Gu-Ming Li, Jia-Yi Li, Wen-Ge World J Clin Cases Case Report BACKGROUND: About 70%-80% of patients with primary membranous nephropathy (MN) have phospholipase A2 receptor (PLA2R) in renal tissue. Systemic light-chain (AL) amyloidosis is the most common type of amyloidosis. MN complicated with amyloidosis is rare. CASE SUMMARY: A 48-year-old Chinese male presented with nephrotic syndrome, positive serum PLA2R antibody, and positive serum and urine IgG-lambda type M-protein, with a normal ratio of serum-free light-chain level. The patient was diagnosed with MN accompanied by AL amyloidosis. He was treated with rituximab with glucocorticoids and CyBorD regimen of chemotherapy. After 21 mo of follow-up, the patient achieved complete remission regarding nephrotic syndrome without adverse effects of chemotherapy. CONCLUSION: We report a case of PLA2R-related MN complicated with primary AL amyloidosis only with renal involvement and successfully treated with rituximab, glucocorticoids and chemotherapy. Baishideng Publishing Group Inc 2023-08-16 2023-08-16 /pmc/articles/PMC10450367/ /pubmed/37637680 http://dx.doi.org/10.12998/wjcc.v11.i23.5538 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Case Report
Zhang, Jiao
Wang, Xu
Zou, Gu-Ming
Li, Jia-Yi
Li, Wen-Ge
Membranous nephropathy with systemic light-chain amyloidosis of remission after rituximab therapy: A case report
title Membranous nephropathy with systemic light-chain amyloidosis of remission after rituximab therapy: A case report
title_full Membranous nephropathy with systemic light-chain amyloidosis of remission after rituximab therapy: A case report
title_fullStr Membranous nephropathy with systemic light-chain amyloidosis of remission after rituximab therapy: A case report
title_full_unstemmed Membranous nephropathy with systemic light-chain amyloidosis of remission after rituximab therapy: A case report
title_short Membranous nephropathy with systemic light-chain amyloidosis of remission after rituximab therapy: A case report
title_sort membranous nephropathy with systemic light-chain amyloidosis of remission after rituximab therapy: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10450367/
https://www.ncbi.nlm.nih.gov/pubmed/37637680
http://dx.doi.org/10.12998/wjcc.v11.i23.5538
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