ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation

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Clinical and pathological features of renal disease associated with Waldenstrm macroglobulinemia

  

  • Online:2020-06-28 Published:2020-07-07

Abstract:

Objective:To investigate clinical and pathological characters of renal disease associated with Waldenstrm macroglobulinemia (WM).
Methodology:Clinical features,laboratory and pathological data of WM patients with renal involvement recruited from Jan 2002 to September 2019 were retrospectively analyzed.
Results:16 (11 males and 5 females)patients were included with a mean age of 609±113 years old.Renal dysfunction was the initial presentation in 11 patients,serum creatinine(SCr) was 1838(769~3597) μmol/L.IgM elevated in all 16 cases,of which 12 cases had hyperglobulinemia.Immunofixation electrophoresis showed monoclonal IgM in 11 cases,abnormal free light chain ratio in 15 cases,anemia in 16 cases.Rectal mucosa amyloidosis were proved in 3 cases.8 patients underwent renal biopsy,3 of them were diagnosed as glomeruli mesangial hyperplasia,while others were diagnosed minimal change of glomeruli,glomerular endothelial change,membranousproliferative glomerular nephritis,glomerular capillary loop wrinkle,κlight chain deposition disease separately.11 patients received chemotherapy after diagnosis,3 patients received immunoadsorption.6 patients died,8 survived and 2 patients lost followup.Among the survived patients,1 patient advanced to multiple myeloma and 4 patients got remission.
Conclusion:Renal disease associated with WM mostly occur in middleaged males,with a high incidence of renal insufficiency and various renal pathological findings.The prognosis of these patients was poor according to our analysis.