Membranoproliferative glomerulonephritis and light-chain nephropathy in association with chronic lymphocytic leukemia

Clin Nephrol. 2008 Dec;70(6):527-31. doi: 10.5414/cnp70527.


The incidence of nephrotic syndrome co-existing with chronic lymphocytic leukemia (CLL) is a rare condition. Almost any glomerular pathology may accompany CLL. The most frequent of all is membranoproliferative glomerulonephritis (MPGN). Moreover, in 5 - 10% of patients with CLL, monoclonal gammopathy may be detected in serum and/or urine samples. There are no well-established treatment protocols for those CLL patients with accompanying nephrotic syndrome. In this case report, we present a 55-year-old female patient diagnosed with CLL, developing nephrotic syndrome, renal dysfunction and IgG k-type monoclonal gammopathy in the follow-up. The renal biopsy revealed glomerular and tubular deposits of k-chain and histopathology of membranoproliferative glomerulonephritis. Rituximab along with CVP (cyclophosphamide - vincristine - prednisolone) chemotherapy regimen was initiated. At the end of 6 courses of treatment, the patient was on "nephrologic" partial remission as the serum creatinine and albumin levels had returned to normal and proteinuria decreased by more than 50%. The patient was also in partial remission for CLL. In conclusion, in patients with CLL and nephrotic syndrome, presence of MPGN along with light-chain nephropathy is rarely reported. Several different treatment protocols are discussed for these patients. Among these regimes, R-CVP is an acceptable alternative for CLL patients with MPGN.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biopsy
  • Cyclophosphamide / therapeutic use
  • Female
  • Follow-Up Studies
  • Glomerulonephritis, Membranoproliferative / diagnosis
  • Glomerulonephritis, Membranoproliferative / drug therapy
  • Glomerulonephritis, Membranoproliferative / etiology*
  • Humans
  • Immunoglobulin kappa-Chains / metabolism*
  • Kidney Glomerulus / metabolism*
  • Kidney Glomerulus / pathology
  • Leukemia, Lymphocytic, Chronic, B-Cell / complications*
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy
  • Leukemia, Lymphocytic, Chronic, B-Cell / pathology
  • Middle Aged
  • Paraproteinemias / drug therapy
  • Paraproteinemias / etiology*
  • Paraproteinemias / metabolism
  • Prednisone / therapeutic use
  • Rituximab
  • Vincristine / therapeutic use


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents
  • Immunoglobulin kappa-Chains
  • Rituximab
  • Vincristine
  • Cyclophosphamide
  • Prednisone

Supplementary concepts

  • COP protocol 2