Renal involvement of intravascular large B-cell lymphoma: a challenging diagnosis
Renal involvement of intravascular large B-cell lymphoma: a challenging diagnosis
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DOI：
10.1007/s40620-021-01109-8
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发表时间：
2021-07-06
影响因子：
3.4
通讯作者：
Koziolek, Michael Johann
中科院分区：
文献类型：
--
作者：
Hakroush, Samy;Lehnig, Luca-Yves;Koziolek, Michael Johann
一位46岁的白人女性在我科住院，以检验风湿性疾病的临床假设。她表现为发热高达41 ℃，体重减轻10公斤，疲劳和盗汗。先前进行了广泛的检查，发现肝脾肿大，贫血，蛋白尿和炎症标志物的非特异性增加，但没有作出准确的诊断。广谱抗生素治疗无效。临床检查显示脾肿大，无明显淋巴结，而其余检查无异常。实验室检查显示正常色素正常红细胞贫血、白细胞减少和肝酶升高。C反应蛋白、降钙素原、铁蛋白和可溶性白细胞介素2受体显著升高。肾脏检查表明肾功能降低，选择性白蛋白尿为2.1 g/g肌酐。常见风湿性疾病的血清学试验为阴性（补充表1）。其他血清学分析，包括甲型、B、丙型肝炎、HIV、钩端螺旋体病、疟疾和结核病血清学，
A 46-year-old Caucasian woman was hospitalized in our department to test the clinical hypothesis of a rheumatic disease. She presented with fever up to 41 C, weight loss of 10 kg, fatigue and night sweats. Prior extensive examinations had been carried out and revealed hepatosplenomegaly, anemia, proteinuria and an unspecific increase in inflammatory markers, but no precise diagnosis was made. Wide spectrum antibiotic treatment was ineffective. Clinical examination revealed splenomegaly without evident lymph nodes, while the rest of the examination was unremarkable.Laboratory testing showed normochromic normocytic anemia, leukopenia and elevated liver enzymes. C-reactive protein, procalcitonin, ferritin, and soluble interleukin 2 receptor were significantly increased. Renal work-up indicated reduction of the kidney function with selective albuminuria of 2.1 g/g creatinine. Serological tests for common rheumatic diseases were negative (Supplemental Table 1). Additional serological analyses including hepatitis A, B, C, HIV, leptospirosis, malaria, and tuberculosis serology and