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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2016  |  Volume : 27  |  Issue : 4  |  Page : 816-820
Minimal change disease: A case report of an unusual relationship


1 Department of Medicine, Division of Nephrology, Washington University School of Medicine, Barnes Jewish Hospital, Saint Louis, MO, USA
2 Division of Renal Medicine, Saint Vincent Hospital; Reliant Medical Group, Worcester, MA, USA
3 Department of Hematology Oncology, Saint Vincent Hospital; Reliant Medical Group, Worcester, MA, USA
4 Department of Renal Pathology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA

Correspondence Address:
Fahad Edrees
Washington University School of Medicine, Barnes Jewish Hospital, St. Louis, MO 63110
USA
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DOI: 10.4103/1319-2442.185271

PMID: 27424706

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Kidney injury associated with lymphoproliferative disorders is rare, and the exact pathogenetic mechanisms behind it are still poorly understood. Glomerular involvement presenting as a nephrotic syndrome has been reported, usually secondary to membranoproliferative glomerulonephritis. We report a case of a 63-year-old male who presented with bilateral leg swelling due to nephrotic syndrome and acute kidney injury. A kidney biopsy showed minimal change disease with light chain deposition; however, no circulating light chains were present. This prompted a bone marrow biopsy, which showed chronic lymphocytic leukemia (CLL) with deposition of the same kappa monoclonal light chains. Three cycles of rituximab and methylprednisolone resulted in remission of both CLL and nephrotic syndrome, without recurrence during a three-year follow-up.


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