Zhang J, Wang X, Zou GM, Li JY, Li WG. Membranous nephropathy with systemic light-chain amyloidosis of remission after rituximab therapy: A case report. World J Clin Cases 2023; 11(23): 5538-5546 [PMID: 37637680 DOI: 10.12998/wjcc.v11.i23.5538]
Corresponding Author of This Article
Wen-Ge Li, MD, PhD, Professor, Department of Nephrology, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Beijing 100029, China. wenge_lee2002@126.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Zhang J, Wang X, Zou GM, Li JY, Li WG. Membranous nephropathy with systemic light-chain amyloidosis of remission after rituximab therapy: A case report. World J Clin Cases 2023; 11(23): 5538-5546 [PMID: 37637680 DOI: 10.12998/wjcc.v11.i23.5538]
World J Clin Cases. Aug 16, 2023; 11(23): 5538-5546 Published online Aug 16, 2023. doi: 10.12998/wjcc.v11.i23.5538
Membranous nephropathy with systemic light-chain amyloidosis of remission after rituximab therapy: A case report
Jiao Zhang, Xu Wang, Gu-Ming Zou, Jia-Yi Li, Wen-Ge Li
Jiao Zhang, Beijing University of Chinese Medicine, Beijing 100029, China
Xu Wang, Gu-Ming Zou, Jia-Yi Li, Wen-Ge Li, Department of Nephrology, China-Japan Friendship Hospital, Beijing 100029, China
Author contributions: Zhang J contributed to the collection of data, drafting and revising of the manuscript; Wang X contributed to the follow-up of the patient; Li JY and Zou GM provided pathological assistance; Li WG contributed to the treatment of the patient and the revision of the manuscript; All authors read and approved the final manuscript.
Informed consent statement: The study has been approved by the ethics committee of the China-Japan Friendship Hospital. Written informed consent was obtained from the individual for the publication of any potentially identifiable images or data included in this article.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Ge Li, MD, PhD, Professor, Department of Nephrology, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Beijing 100029, China. wenge_lee2002@126.com
Received: March 31, 2023 Peer-review started: March 31, 2023 First decision: July 3, 2023 Revised: July 17, 2023 Accepted: July 25, 2023 Article in press: July 25, 2023 Published online: August 16, 2023 Processing time: 137 Days and 16.9 Hours
Abstract
BACKGROUND
About 70%-80% of patients with primary membranous nephropathy (MN) have phospholipase A2 receptor (PLA2R) in renal tissue. Systemic light-chain (AL) amyloidosis is the most common type of amyloidosis. MN complicated with amyloidosis is rare.
CASE SUMMARY
A 48-year-old Chinese male presented with nephrotic syndrome, positive serum PLA2R antibody, and positive serum and urine IgG-lambda type M-protein, with a normal ratio of serum-free light-chain level. The patient was diagnosed with MN accompanied by AL amyloidosis. He was treated with rituximab with glucocorticoids and CyBorD regimen of chemotherapy. After 21 mo of follow-up, the patient achieved complete remission regarding nephrotic syndrome without adverse effects of chemotherapy.
CONCLUSION
We report a case of PLA2R-related MN complicated with primary AL amyloidosis only with renal involvement and successfully treated with rituximab, glucocorticoids and chemotherapy.
Core Tip: We report a rare case of phospholipase A2 receptor-related membranous nephropathy complicated with primary systemic light-chain amyloidosis with only renal involvement. The patient achieved complete remission after receiving rituximab, glucocorticoids and CyBorD regimen chemotherapy. Additionally, we conducted a literature review to provide current evidence on early diagnosis and treatment of this disease.
