IgG4-related tubulointerstitial nephritis and lymphadenopathy after therapy for malignant lymphoma

Intern Med. 2012;51(10):1221-6. doi: 10.2169/internalmedicine.51.6691. Epub 2012 May 15.

Abstract

We report a middle-aged Japanese man who had a past history of malignant lymphoma with tubulointerstitial nephritis (TIN) presenting a high serum immunoglobulin G4 (IgG4) concentration and bilateral kidney enlargement and swelling of many lymph nodes. Although lymph node biopsy was not evident of a recurrence of lymphoma, kidney biopsy showed prominent infiltration of IgG4-positive plasma cells in a tubulointerstitial lesion but not in glomeruli. We made a diagnosis of IgG4-related TIN and lymphadenopathy; administration of oral prednisolone improved his physical and laboratory parameters. This is the first report of a case of IgG4-related TIN and lymphadenopathy after therapy for malignant lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / therapy
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin G / metabolism*
  • Lymphatic Diseases / drug therapy
  • Lymphatic Diseases / etiology*
  • Lymphatic Diseases / immunology
  • Lymphatic Diseases / pathology
  • Lymphoma, Follicular / complications
  • Lymphoma, Follicular / therapy*
  • Male
  • Nephritis, Interstitial / drug therapy
  • Nephritis, Interstitial / etiology*
  • Nephritis, Interstitial / immunology
  • Nephritis, Interstitial / pathology
  • Prednisolone / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Immunoglobulin G
  • Prednisolone