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A Case of waldenström macroglobulinemia with Acute Kidney Injury as the First manifestation and Literature Review

Proceedings of Anticancer Research 2024年第3期8卷 127-132页

作者： Yang Xu Shanshan Guo Yanli Gou Xijie Zheng Department of Nephrology Affiliated Hospital of Hebei UniversityBaoding 071000Hebei ProvinceChina

waldenström macroglobulinemia is a rare lymphoid tumor accounting for 2% of all hematological malignancies. Renal complications are less common compared to multiple myeloma, with the most frequent renal manifestations being microproteinuria and microhematuria. This paper presents a case of waldenström macroglobulinemia with acute kidney injury as the initial manifestation. A 75-year-old male was admitted to the Affiliated Hospital of Hebei University after elevated blood creatinine levels were detected for one day. Upon admission, his blood creatinine was 255 μmol/L, urine protein was 1+, urine erythrocytes were negative, electrophoresis showed Igm positivity in the κ-region, and a bone marrow biopsy indicated a tendency towards lymphoplasmacytic lymphoma. The patient was discharged after receiving a treatment regimen of prednisone acetate, thalidomide, and cyclophosphamide, and continued oral medication outside the hospital. The patient returned two weeks later due to diarrhea and was found to have a blood creatinine level of 985 μmol/L, along with severe acidosis and hyperkalemia. The patient refused renal replacement therapy and was not followed up, resulting in a poor prognosis. Additionally, a review of the literature is provided to contextualize this case within the broader scope of existing research.

关键词： waldenström macroglobulinemia Acute kidney injury Prognosis Literature review

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Optical coherence tomography angiography characteristics in waldenström macroglobulinemia retinopathy:A case report

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World Journal of Clinical Cases 2020年第23期8卷 6071-6079页

作者： Jun Li Rui Zhang Feng Gu Zhe-Li Liu Peng Sun Department of Ophthalmology The First Hospital of China Medical UniversityShenyang 110001Liaoning ProvinceChina Department of Hematology The First Hospital of China Medical UniversityShenyang 110001Liaoning ProvinceChina

BACKGROUND waldenström macroglobulinemia(Wm)is a distinct clinicopathologic entity characterized by the infiltration of the bone marrow by clonal lymphoplasmacytic cells that produce monoclonal immunoglobulin m(Igm)in the blood,and patients may present with symptoms related to the infiltration of the hematopoietic tissues or the effects of monoclonal Igm in the *** abnormalities were noted in some of the patients due to hyperviscosity or other retinal *** coherence tomography angiography(OCTA)as a noninvasive imaging tool can give qualitative and quantitative information about the status of retinal and choroidal vessels,which might be useful for diagnosing patients with Wm-associated *** SUmmARY The patient was a 67-year-old man who presented with sudden visual disturbance in both *** tests showed that best corrected visual acuity(BCVA)for this patient was 20/100 in the right eye and 20/1000 in the left *** examination,optical coherence tomography(OCT),and OCTA revealed substantial bilateral optic disc edema,dilated and tortuous retinal veins,and diffuse intraretinal blot hemorrhages and edema which were consistent with bilateral central retinal vein occlusion(CRVO).meanwhile,remarkable bilateral serous macular detachments(SmD)were noticed on *** examinations showed that the patient had anemia and extremely high level of monoclonal Igm and infiltration of clonal lymphoplasmacytic cells in bone *** diagnosis of Wm with hyperviscosity and retinopathy was made based on the clinical manifestation and laboratory *** was subsequently treated with intravitreal ranibizumab injection,plasmapheresis,and bortezomib plus rituximab with *** months after treatments,the central macular volume decreased by 16.1%in the right eye and 28.6%in the left eye on OCT,and the patient’s BCVA was improved to 20/60 in the right eye and 20/400 in the left *** good partial response was obtained a

关键词： waldenström macroglobulinemia Retinal vein occlusion Ranibizumab Optical coherence tomography angiography Ophthalmology Case report

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Extensive multifocal and pleomorphic pulmonary lesions in waldenstrom macroglobulinemia: A case report

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World Journal of Clinical Cases 2020年第11期8卷 2305-2311页

作者： De-Feng Zhao Hao-Yong Ning Jian Cen Yi Liu Li-Ren Qian Zhi-Hai Han Jian-Liang Shen Department of Hematology Beijing Boren HospitalBeijing 100070China Department of Pathology Navy General Hospital of PLABeijing 100048China Department of Hematology Navy General Hospital of PLABeijing 100048China Department of Respiratory Care Navy General Hospital of PLABeijing 100048China

BACKGROUND waldenstrom macroglobulinemia(Wm) is a type of small lymphocytic lymphoma that mainly affects the bone marrow, spleen, and lymph nodes. A subset of patients with Wm demonstrates extramedullary involvement(4.4%),and the most frequent extramedullary disease site involved is the lungs(30%).CASE SUmmARY A 60-year-old male patient who experienced intermittent breath-holding for 6 mo was admitted on August 14, 2017. Chest computed tomography indicated multiple pulmonary cavities in the upper lobes of both lungs, with pulmonary consolidation, ground-glass opacities, patchy infiltrates, fibrous bands, large bullae, and enlarged lymph nodes in the mediastinum. The patient was a heavy smoker(20 cigarettes/d for 40 years). Diagnostic fiberoptic bronchoscopy revealed normal findings. Serological examination revealed a remarkable increase in serum immunoglobulin m levels(30.24 g/L;normal: 0.4-2.30 g/L). A computed tomography-guided percutaneous pulmonary biopsy was performed in the left lower lobe of the lung with pulmonary consolidation and indicated that the alveolar structure disappeared and that a large amount of amyloid-like deposition was present along with the infiltration of very few lymphocytes and plasma cells. The patient was treated with the combined treatment of dexamethasone + rituximab + lenalidomide over four courses. Serum immunoglobulin m did not normalize, and he received ibrutinib +*** This patient with Wm and lung amyloidosis had a wide range of pulmonary lesions and a variety of morphological features, which was a rare case. Yet, some changes might be ascribed to heavy smoking.

关键词： waldenström macroglobulinemia Lung Amyloidosis Computed tomography Case report

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