Key result
Intravascular large B-cell lymphoma limited to the glomerular capillaries presented with a normal C-reactive protein level of /dl despite rapidly progressive renal dysfunction.
Case Report (n=1)
No
Intravascular large B-cell lymphoma limited to the intraglomerular capillaries may present without elevated CRP levels.
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Normal CRP does not exclude glomerular-limited IVLBCL in rapidly progressive renal failure; extends phenotypic spectrum but remains hypothesis-generating.
A 65-year-old woman was admitted to our hospital for the evaluation of rapidly progressive renal dysfunction with serum creatinine of 2.7 mg/dl and urinary protein of 1.5 g daily. C-reactive protein (CRP) was 0.1 mg/dl. Kidney-limited intravascular large B-cell lymphoma (IVL) localized to the glomerular capillaries was diagnosed because the intraglomerular cells were positive for CD20 and CD79a, while there was no positivity in the extraglomerular kidney and extrarenal organs. Treatment with rituximab, cyclophosphamide, hydroxydaunomycin, vincristine, and prednisolone was started, and the patient has since been doing well. When IVL is limited to the intraglomerular capillaries, CRP may not be elevated.
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Hasegawa et al. (2015) conducted a case report in Intravascular large B-cell lymphoma limited to the glomerular capillaries (n=1). Rituximab, cyclophosphamide, hydroxydaunomycin, vincristine, and prednisolone was evaluated. Intravascular large B-cell lymphoma limited to the glomerular capillaries presented with a normal C-reactive protein level of /dl despite rapidly progressive renal dysfunction.
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