A case of Castleman's disease complicated with nephrotic syndrome due to glomerulopathy mimicking membranoproliferative glomerulonephritis

Am J Med Sci. 2008 Jun;335(6):495-8. doi: 10.1097/MAJ.0b013e3181571f7e.

Abstract

Castleman's disease is a rare atypical lymphoproliferative disorder. Renal manifestations, such as proteinuria, hematuria, and renal dysfunction, are common in Castleman's disease; however, a nephrotic syndrome rarely occurs. We have encountered an unusual case of Castleman's disease of the plasma cell type characterized by nephrotic syndrome because of glomerulopathy mimicking membranoproliferative glomerulonephritis. Our patient showed higher levels of circulating cytokines (interleukin-6/vascular endothelial cell-derived growth factor), the glomerular lesions not associated with immunocomplex deposition, and the resolution of nephrotic syndrome after successful corticosteroids therapy resulting in a decline in cytokines levels, thereby implicating a cytokine-induced glomerular cell injury/activation as a possible cause of the glomerular pathological changes in this case.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Castleman Disease / complications*
  • Castleman Disease / drug therapy
  • Castleman Disease / pathology
  • Diagnosis, Differential
  • Female
  • Glomerulonephritis / complications
  • Glomerulonephritis / drug therapy
  • Glomerulonephritis / pathology
  • Glomerulonephritis, Membranoproliferative / complications
  • Glomerulonephritis, Membranoproliferative / drug therapy
  • Glomerulonephritis, Membranoproliferative / pathology*
  • Humans
  • Kidney Glomerulus / ultrastructure*
  • Middle Aged
  • Nephrotic Syndrome / complications*
  • Nephrotic Syndrome / drug therapy
  • Nephrotic Syndrome / pathology
  • Prednisolone / therapeutic use
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Prednisolone