Sindrome nefrosica in paziente con linfoma linfoplasmocitoide: trattamento con Rituximab

Lymphoplasmacytic lymphoma (LLP) is a B-cell low-grade lymphoproliferative disorder, characterized by indolent clinical course. Renal involvement as part of primitive LLP is extremely rare. We describe the case of a 61 years-old man, in good clinical conditions with diagnosis of MGUS since 2006. The patient came to our observation in 2009 because of acute renal failure in the contest of nephrotic syndrome and normocytic anemia, increase β2-microglobulin and presence of Bence-Jones proteinuria. The bone marrow biopsy documented findings suggestive for LLP. The patient was treated with Rituximab, a monoclonal antibody against CD20, associated with hemodyalises; progressively we observed a recovery, almost complete and lasting, of renal function and patient’s clinical conditions till the most recent follow-up visit. The success of therapy with Rituximab shows the close correlation between lymphoproliferative disorder and renal involvement.