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Duvaltier L, El Karoui K, Bosselut N, Boutan-Laroze A, Boffa JJ, Buob D, Brousse R. The Case | A paraneoplastic kidney injury? Kidney Int 2023; 104:401-402. [PMID: 37479389 DOI: 10.1016/j.kint.2023.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/15/2023] [Accepted: 05/25/2023] [Indexed: 07/23/2023]
Affiliation(s)
- Lucile Duvaltier
- Sorbonne Université, INSERM UMRS 1155, Nephrology Department, Assistance Publique Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Khalil El Karoui
- Sorbonne Université, INSERM UMRS 1155, Nephrology Department, Assistance Publique Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Nelly Bosselut
- Université Paris Cité, Department of Cellular Biology, Saint-Louis Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | | | - Jean-Jacques Boffa
- Sorbonne Université, INSERM UMRS 1155, Nephrology Department, Assistance Publique Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - David Buob
- Sorbonne Université, Department of Pathology, Assistance Publique Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Romain Brousse
- Sorbonne Université, INSERM UMRS 1155, Nephrology Department, Assistance Publique Hôpitaux de Paris, Hôpital Tenon, Paris, France.
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Kudose S, Cossey LN, Canetta PA, Sekulic M, Vanbeek CA, Huls FB, Gupta I, Bu L, Alexander MP, Cornell LD, Fidler ME, Markowitz GS, Larsen CP, D’Agati VD, Nasr SH, Santoriello D. Clinicopathologic Spectrum of Lysozyme-Associated Nephropathy. Kidney Int Rep 2023; 8:1585-1595. [PMID: 37547521 PMCID: PMC10403676 DOI: 10.1016/j.ekir.2023.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 05/08/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Lysozyme-associated nephropathy (LyN), a rare cause of kidney injury in patients with chronic myelomonocytic leukemia (CMML), has not been well described to date. We report the clinicopathologic spectrum of LyN from a multi-institutional series. Method We identified 37 native kidney biopsies with LyN and retrospectively obtained clinicopathologic data. Results Thirty-seven patients had a median age of 74 years and included 78% males. Their most common presentation was acute kidney injury (AKI) or AKI on chronic kidney disease (CKD) (66%) with median estimated glomerular filtration rate (eGFR) of 21.7 ml/min per 1.73 m2, and proteinuria of 1.7 g. A minority (15%) had partial Fanconi syndrome. Serum lysozyme levels were elevated in all tested. Hematologic disorder (n = 28, 76%) was the most common etiology, including CMML (n = 15), acute myeloid leukemia (n = 5), and myelodysplastic syndrome (MDS) (n = 5). Nonhematologic causes (n = 5, 14%), included metastatic neuroendocrine carcinoma (n = 3), sarcoidosis, and leprosy. Etiology was unknown in 4 (11%). Pathology showed proximal tubulopathy with abundant hypereosinophilic intracytoplasmic inclusions, with characteristic staining pattern by lysozyme immunostain. Mortality was high (8/30). However, among the 22 alive, including 85% treated, 7 had improved kidney function, including 1 who discontinued dialysis and 6 with increase in eGFR >15 ml/min per 1.73 m2 compared with eGFR at the time of biopsy. Conclusion Increased awareness of the full clinicopathologic spectrum of LyN may lead to prompt diagnosis, earlier treatment, and potentially improved outcome of this rare entity.
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Affiliation(s)
- Satoru Kudose
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Pietro A. Canetta
- Department of Medicine, Division of Nephrology, Columbia University Irving Medical Center, New York, New York, USA
| | - Miroslav Sekulic
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Forest B. Huls
- Department of Pathology, Division of Laboratory Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Isha Gupta
- Middletown Medical, Middletown, New York, USA
| | - Lihong Bu
- Mayo Clinic, Rochester, Minnesota, USA
| | | | | | | | - Glen S. Markowitz
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Vivette D. D’Agati
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Dominick Santoriello
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
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Hakroush S, Schridde L, Wallbach M, Mekolli A, Korsten P, Tampe B. Low Efficacy of Chromogranin A Elimination by Therapeutic Plasma Exchange for Treatment of Chromogranin A Tubulopathy. Kidney Int Rep 2021; 6:3093-3094. [PMID: 34901579 PMCID: PMC8640534 DOI: 10.1016/j.ekir.2021.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022] Open
Affiliation(s)
- Samy Hakroush
- Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany
| | - Laura Schridde
- Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany
| | - Manuel Wallbach
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
| | - Ardian Mekolli
- Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany
| | - Peter Korsten
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
| | - Björn Tampe
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
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