| Autor: |
De La Flor JC; Department of Nephrology, Hospital Central Defense Gomez Ulla, 28047 Madrid, Spain., Sulca JM; Department of Nephrology, Hospital Cayetano Heredia, Lima 15002, Peru., Rodríguez P; Department of Nephrology, Guadalajara Center Dialysis, AVERICUM, 19003 Guadalajara, Spain., Villa D; Department of Nephrology, Clínica Universidad de Navarra, 31008 Navarra, Spain., Sandoval E; Department of Hematology, Hospital Central Defense Gomez Ulla, 28047 Madrid, Spain., Zamora R; Department of Nephrology, Hospital Universitario General Villalba, 28400 Madrid, Spain., Monroy-Condori M; Department of Nephrology, Hospital General Universitario Nuestra Señora del Prado, 45600 Talavera de la Reina, Spain., Lipa R; Department of Anatomical Pathology, Instituto Nacional de Salud del Niño-San Borja, Lima 15037, Peru., Perez H; Department of Nephrology, Hospital Cayetano Heredia, Lima 15002, Peru., Cieza M; Department of Nephrology, Hospital Cayetano Heredia, Lima 15002, Peru. |
| Abstrakt: |
Cryoglobulins are immunoglobulins that precipitate at temperatures below 37 °C and dissolve upon reheating. They can induce small-vessel vasculitis with renal involvement. Cryoglobulinemic glomerulonephritis is a rare manifestation that occurs in patients with monoclonal gammopathy, specifically Waldenström's macroglobulinemia. We present the case of a 52-year-old patient with a history of cutaneous vasculitis and hypothyroidism, who presented with generalized edema, moderate anemia, hypercholesterolemia, nephrotic range proteinuria of 12.69 g/day, microhematuria, arterial hypertension, and hypocomplementemia via the classical pathway, without acute kidney injury and with negative serological studies and positive cryoglobulins in the second determination. Serum and urine protein electrophoresis and immunofixation studies showed a monoclonal band of IgM and kappa light chain. Renal biopsy was consistent with cryoglobulinemic glomerulonephritis. In the context of dysproteinemia and cryoglobulinemic glomerulonephritis, bone-marrow aspiration and biopsy were performed, leading to the diagnosis of Waldenström's macroglobulinemia. Monoclonal gammopathies have been described in association with type I cryoglobulinemias. This described association is uncommon, which is why we present this case, along with a review of the literature. |
