Mott cell interstitial nephritis revealing Waldenström macroglobulinaemia
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A 77-year-old man was referred to our department for a recent deterioration of renal function. Relevant medical history included hypertension, type 2 diabetes, and calreticulin-mutated essential thrombocythemia with myelofibrosis. A monoclonal IgM spike, considered to correspond to a monoclonal gammopathy of undetermined significance (MGUS), had been diagnosed 25 years earlier.
Physical examination revealed lower limb edema and isolated splenomegaly without enlarged palpable lymph nodes or peripheral neuropathy. Laboratory investigations revealed an impairment of renal function (creatinine = 170 μmol/L versus 115 μmol/L 2 years ago) associated with marked proteinuria (3.2 g/day) and normal albumin concentration. The patient also exhibited anemia (9.8 g/dl) and thrombocytosis (720,000/mm3) but electrolyte concentrations were normal. Immunoelectrophoresis analysis demonstrated the presence of a circulating monoclonal IgMκ (4 g/L). Immunonephelometric assays confirmed the...
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The authors declare that they have no conflict of interest.
Informed consent was obtained from all individual participants included in the study.
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