Acute renal failure secondary to severe type I cryoglobulinemia following rituximab therapy for Waldenström’s macroglobulinemia

Abstract

Waldenström’s macroglobulinemia is rare lymphoproliferative disorder characterized by the presence of a monoclonal IgM paraproteinemia. Cryoglobulinemia is a common sequela of Waldenström’s macroglobulinemia present in 8–18% of the patients. Cryoglobulinemia has also been described as occurring after treatment with rituximab. In the previous report, the cryoglobulinemia was a transient phenomenon and did not carry any adverse effect. We present a case of an 80-year-old male with Waldenström’s macroglobulinemia in whom the rituximab-induced cryoglobulinemia resulted in acute renal failure and a vasculitic rash. Cryoglobulins level reached a peak of 63%. The patient was successfully treated with plasmapheresis, chlorambucil and prednisone, with near-complete recovery of renal function. As this case illustrates, the rituximab-induced cryoglobulin is not always benign. Pre- and post-treatment monitoring of the cryoglobulin level is advised in these patients.

DOI: 10.1007/s10157-008-0042-9

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Cite this paper

@article{Shaikh2008AcuteRF, title={Acute renal failure secondary to severe type I cryoglobulinemia following rituximab therapy for Waldenstr{\"{o}m’s macroglobulinemia}, author={Aisha Shaikh and Thomas Matthew Habermann and Mary E. Fidler and Shaji K Kumar and Nelson Leung}, journal={Clinical and Experimental Nephrology}, year={2008}, volume={12}, pages={292-295} }