만성 림프구성 백혈병 환자에서 병발한 신아밀로이드증 1예

Abstract

The nephrotic syndrome is uncommon in patients with chronic lymphocytic leukemia. When present, the most frequently documented cause is membrano-proliferative glomerulonephritis, although several other glomerular lesions have also been described. This report describes a patient with renal amyloidosis associated with chronic lymphocytic leukemia. A 70-year-old male patient was admitted to the hospital because of multiple lymph nodes enlargement, general weakness and generalized edema. Hematologic findings showed marked leukocytosis (39,500/mm3 with 79% mature lymphocytes). Laboratory findings included a serum creatinine level of 2.0mg/dL, urinary protein excretion of 9.1g/day, and free monoclonal IgG, A chain in serum and urine. A diagnosis of CLL was made on the basis of hyperlymphocytosis and typical bone marrow findings by aspiration and biopsy. Percutaneous renal biopsy revealed amyloid deposits in glomeruli, vessel walls, interstitium. He was died of sepsis and myocardial infarction at 3 weeks after diagnosis.