Waldenstrom’s Macroglobulinemia: A Report of Two Cases, One with Severe Retinopathy and One with Renal Failure
We report here two cases of Waldenstrom’s macroglobulinemia (WM), one with central nervous system (CNS) symptoms and severe retinopathy and one with renal failure. In both cases, the serum IgM levels exceeded 3,000 mg/dL and monoclonal IgM-kappa was observed in the blood. At onset, Case 1, a 63-year...
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| Format: | Article |
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Wiley
2017-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2017/3732902 |
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| author | Naoko Kudo Masakatsu Usui Yukiharu Nakabo Ken-ichi Yoshida Kenji Miki Takashi Osafune Keisuke Nishimura Shinsaku Imashuku |
| author_facet | Naoko Kudo Masakatsu Usui Yukiharu Nakabo Ken-ichi Yoshida Kenji Miki Takashi Osafune Keisuke Nishimura Shinsaku Imashuku |
| author_sort | Naoko Kudo |
| collection | DOAJ |
| description | We report here two cases of Waldenstrom’s macroglobulinemia (WM), one with central nervous system (CNS) symptoms and severe retinopathy and one with renal failure. In both cases, the serum IgM levels exceeded 3,000 mg/dL and monoclonal IgM-kappa was observed in the blood. At onset, Case 1, a 63-year-old female, developed CNS symptoms—namely, drowsiness and syncope. Case 2, a 58-year-old male, had nausea and dysgeusia on admission associated with renal failure, which is quite rare in patients with WM. Both patients exhibited hyperviscosity-related retinopathy, but it was particularly severe in Case 1: she suddenly lost her vision after admission. However, her vision recovered completely during treatment. Case 2 required hemodialysis immediately after admission. Needle biopsy of his kidney revealed tubulointerstitial nephritis with marked infiltration with CD20-positive lymphoplasmacytic lymphoma cells. After treatment, Case 1 has been in a remission longer than 8 years, but Case 2 died of pneumonia in 6 months. Since the initial symptoms of WM are ambiguous and vary significantly and hyperviscosity-related ophthalmological problems or severe renal dysfunction can arise, it is essential to promptly measure serum IgM levels and to institute appropriate care immediately when WM is confirmed in a patient. |
| format | Article |
| id | doaj-art-855c70005e1349e6bfbdd55b790a3900 |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-855c70005e1349e6bfbdd55b790a39002025-02-03T06:13:25ZengWileyCase Reports in Hematology2090-65602090-65792017-01-01201710.1155/2017/37329023732902Waldenstrom’s Macroglobulinemia: A Report of Two Cases, One with Severe Retinopathy and One with Renal FailureNaoko Kudo0Masakatsu Usui1Yukiharu Nakabo2Ken-ichi Yoshida3Kenji Miki4Takashi Osafune5Keisuke Nishimura6Shinsaku Imashuku7Division of Hematology, Takasago-seibu Hospital, Takasago 676-0812, JapanDepartment of Internal Medicine, Uji-Tokushukai Medical Center, Uji 611-0042, JapanThe Center for Hematological Diseases, Takeda General Hospital, Kyoto 601-1495, JapanDivision of Ophthalmology, Takasago-seibu Hospital, Takasago 676-0812, JapanDepartment of Internal Medicine, Uji-Tokushukai Medical Center, Uji 611-0042, JapanDepartment of Urology, Uji-Tokushukai Medical Center, Uji 611-0042, JapanDepartment of Pathology, Uji-Tokushukai Medical Center, Uji 611-0042, JapanDivision of Hematology, Takasago-seibu Hospital, Takasago 676-0812, JapanWe report here two cases of Waldenstrom’s macroglobulinemia (WM), one with central nervous system (CNS) symptoms and severe retinopathy and one with renal failure. In both cases, the serum IgM levels exceeded 3,000 mg/dL and monoclonal IgM-kappa was observed in the blood. At onset, Case 1, a 63-year-old female, developed CNS symptoms—namely, drowsiness and syncope. Case 2, a 58-year-old male, had nausea and dysgeusia on admission associated with renal failure, which is quite rare in patients with WM. Both patients exhibited hyperviscosity-related retinopathy, but it was particularly severe in Case 1: she suddenly lost her vision after admission. However, her vision recovered completely during treatment. Case 2 required hemodialysis immediately after admission. Needle biopsy of his kidney revealed tubulointerstitial nephritis with marked infiltration with CD20-positive lymphoplasmacytic lymphoma cells. After treatment, Case 1 has been in a remission longer than 8 years, but Case 2 died of pneumonia in 6 months. Since the initial symptoms of WM are ambiguous and vary significantly and hyperviscosity-related ophthalmological problems or severe renal dysfunction can arise, it is essential to promptly measure serum IgM levels and to institute appropriate care immediately when WM is confirmed in a patient.http://dx.doi.org/10.1155/2017/3732902 |
| spellingShingle | Naoko Kudo Masakatsu Usui Yukiharu Nakabo Ken-ichi Yoshida Kenji Miki Takashi Osafune Keisuke Nishimura Shinsaku Imashuku Waldenstrom’s Macroglobulinemia: A Report of Two Cases, One with Severe Retinopathy and One with Renal Failure Case Reports in Hematology |
| title | Waldenstrom’s Macroglobulinemia: A Report of Two Cases, One with Severe Retinopathy and One with Renal Failure |
| title_full | Waldenstrom’s Macroglobulinemia: A Report of Two Cases, One with Severe Retinopathy and One with Renal Failure |
| title_fullStr | Waldenstrom’s Macroglobulinemia: A Report of Two Cases, One with Severe Retinopathy and One with Renal Failure |
| title_full_unstemmed | Waldenstrom’s Macroglobulinemia: A Report of Two Cases, One with Severe Retinopathy and One with Renal Failure |
| title_short | Waldenstrom’s Macroglobulinemia: A Report of Two Cases, One with Severe Retinopathy and One with Renal Failure |
| title_sort | waldenstrom s macroglobulinemia a report of two cases one with severe retinopathy and one with renal failure |
| url | http://dx.doi.org/10.1155/2017/3732902 |
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