Case Report: A Rare Case of Lupus Nephritis Associated With Mantle Cell Lymphoma

Xiao‐Juan Yu ,Rong Xu,Fu-De Zhou ,Hui Wang,Bingjie Wang,Daorina Bao,Ming‐Hui Zhao ,Ying Tan

doi:10.3389/fmed.2021.759279

Abstract

In this research, we described a very rare case of secondary lupus nephritis associated with B-cell lymphoma. An 84-year-old man was hospitalized at our institute for lower extremity edema persisting for over 2 months. He was diagnosed with systemic lupus erythematosus based on clinical and laboratory criteria, which showed impaired renal function and nephrotic syndrome with predominant hematuria. Renal biopsy showed IV+V lupus nephritis with highly infiltrated lymphoid cells in the kidney. Secondary lupus nephritis was suspected based on the possible pathogenesis of glomerular injury due to mantle cell lymphoma. Low-dose dexamethasone, rituximab, and lenalidomide were immediately started on the patient, and his renal function was improved after the first cycle of chemotherapy.

Highlights

Lupus nephritis is a form of glomerulonephritis that constitutes one of the most severe organ manifestations of the autoimmune disease, systemic lupus erythematosus (SLE)
The patient’s antinuclear antibody (ANA) was 1:100, anti-dsDNA levels negative, and Complement 3 (C3) and C4 immediately returned to normal level after just one round of chemotherapy (Figure 2)
Systematic lupus erythematosus (SLE) is an autoimmune disease characterized by multisystem organ involvement, heterogeneity of clinical features, and a variety of degrees of severity, of which lupus nephritis is constituted with one of the most common causes of morbidity and mortality

Summary

BACKGROUND

Lupus nephritis is a form of glomerulonephritis that constitutes one of the most severe organ manifestations of the autoimmune disease, systemic lupus erythematosus (SLE). Renal involvement presented as lupus nephritis is rare [3,4,5,6,7]. We describe a rare case of mixed proliferative and membranous lupus nephritis, secondary to mantle cell lymphoma, and partially recovered after chemotherapy. There was no further chemical treatment for lymphoma because of its indolence and low risk He had a series of metabolic disorders, including diabetes, hypertension, and coronary heart disease, with satisfying controlment and no diabetic retinopathy. Physical examination showed an obvious vicia-sized lymph node at the right axilla, shifting dullness, and severe edema of both lower limbs. Electron microscopy showed that the basement membrane was thickened and diffusely accompanied by sub-epithelial and segmental mesangial electron-dense deposits. The patient’s ANA was 1:100, anti-dsDNA levels negative, and C3 and C4 immediately returned to normal level after just one round of chemotherapy (Figure 2)

DISCUSSION

CONCLUSION

Findings

ETHICS STATEMENT