Jornal de Hematologia e Doenças Tromboembólicas
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Lipid-rich Glomerular Capillary Thrombi, of a Patient with Waldenstrom’s Macroglobulinemia

Masanobu Gunji, Itaru Ebihara, Megumi Koda, Yuki Okubo, Chihiro Sato, Joichi Usui, Kunihiro Yamagata, Masaki Kobayashi and Takao Saito

A 77-year-old woman was diagnosed nephrotic syndrome with Waldenström’s macroglobulinemia (WM). Renal biopsy revealed MPGN-like lesions with extensive glomerular capillary thrombi which were positive for anti-IgM and anti-lambda-light chain immunofluorescence. The electron microscopy showed characteristic thrombi intra glomerular capillary walls which were occupied with a lot of vacuoles. These structures were similar with them of lipoprotein glomerulopathy. The patient was started to treat with R-CHOP, and then nephrotic syndrome and her renal insufficiency were completely recovered. There were no previous reports of nephrotic syndrome and acute renal failure caused by oil-rich intracapillary thrombi in WM in the literature.