{"title":"Unusual Coincidence: Concurrent Cast Nephropathy and Lymphoma Infiltration in an Influenza A-Associated Acute Kidney Injury","authors":"Wan-Ching Lee, Chun-Kuang Tsai, Szu-Yuan Li","doi":"10.1155/2024/5524746","DOIUrl":null,"url":null,"abstract":"Acute kidney injury (AKI) poses a substantial challenge in the management of lymphoma patients and is frequently associated with diverse causative factors. Herein, we report an illustrative case involving a 47-year-old male with influenza A infection who developed severe AKI, which was incongruent with his medical history. Laboratory investigations disclosed aberrant immunoglobulin levels and urinary protein excretion, prompting further evaluation. A renal biopsy revealed the presence of infiltrating lymphoid cells and cast nephropathy, raising suspicion of an underlying hematological disorder. A comprehensive diagnostic workup, including positron emission tomography imaging and bone marrow biopsy, culminated in the definitive diagnosis of splenic marginal zone lymphoma. This case highlights the crucial significance of including lymphoma-associated kidney disorders in the evaluation of unexplained AKI, particularly when encountering unconventional clinical and laboratory results. Swift and precise intervention is of utmost importance in attaining positive results in these rare and complex clinical situations. This study underscores the persistent concern of AKI in lymphoma patients, with lymphocytic infiltration and cast nephropathy as notable elements contributing to the intricate nature of this condition.","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Nephrology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2024/5524746","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Acute kidney injury (AKI) poses a substantial challenge in the management of lymphoma patients and is frequently associated with diverse causative factors. Herein, we report an illustrative case involving a 47-year-old male with influenza A infection who developed severe AKI, which was incongruent with his medical history. Laboratory investigations disclosed aberrant immunoglobulin levels and urinary protein excretion, prompting further evaluation. A renal biopsy revealed the presence of infiltrating lymphoid cells and cast nephropathy, raising suspicion of an underlying hematological disorder. A comprehensive diagnostic workup, including positron emission tomography imaging and bone marrow biopsy, culminated in the definitive diagnosis of splenic marginal zone lymphoma. This case highlights the crucial significance of including lymphoma-associated kidney disorders in the evaluation of unexplained AKI, particularly when encountering unconventional clinical and laboratory results. Swift and precise intervention is of utmost importance in attaining positive results in these rare and complex clinical situations. This study underscores the persistent concern of AKI in lymphoma patients, with lymphocytic infiltration and cast nephropathy as notable elements contributing to the intricate nature of this condition.
急性肾损伤(AKI)是治疗淋巴瘤患者的一大挑战,而且经常与多种致病因素有关。在此,我们报告了一例典型病例,患者为 47 岁男性,感染了甲型流感,出现了严重的急性肾损伤,这与其病史不符。实验室检查发现免疫球蛋白水平和尿蛋白排泄异常,因此需要进一步评估。肾活检显示存在浸润性淋巴细胞和铸型肾病,这引起了对潜在血液病的怀疑。经过包括正电子发射断层扫描成像和骨髓活检在内的全面诊断,最终确诊为脾边缘区淋巴瘤。本病例强调了在评估不明原因的 AKI 时将淋巴瘤相关的肾脏疾病包括在内的重要意义,尤其是在遇到非常规的临床和实验室结果时。在这些罕见而复杂的临床情况下,迅速而精确的干预对于取得积极的结果至关重要。这项研究强调,淋巴瘤患者的 AKI 问题一直备受关注,淋巴细胞浸润和铸型肾病是导致这种情况错综复杂的重要因素。