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  1. Article: Anti-LRP2 nephropathy with concurrent kidney infiltration by lymphoma.

    Gamayo, Ashley / Hecox, Douglas / Dicker, Lance / Vecchiarelli, Lisa / Raess, Philipp W / Khalighi, Mazdak / Andeen, Nicole K

    Clinical kidney journal

    2019  Volume 13, Issue 3, Page(s) 468–472

    Abstract: Anti-low-density lipoprotein receptor-related lipoprotein 2 (LRP2) nephropathy/anti-brush border antibody disease is rare and characterized by tubular basement membrane, Bowman's capsule and glomerular subepithelial immune deposits on kidney biopsy. No ... ...

    Abstract Anti-low-density lipoprotein receptor-related lipoprotein 2 (LRP2) nephropathy/anti-brush border antibody disease is rare and characterized by tubular basement membrane, Bowman's capsule and glomerular subepithelial immune deposits on kidney biopsy. No reported cases have occurred in patients with lymphoproliferative disorders or monoclonal gammopathies. We present two cases of anti-LRP2 nephropathy that occurred in patients with progressive low-grade B-cell lymphoma and had concurrent kidney infiltration by lymphoma on biopsy. We speculate that underlying immune dysregulation related to lymphoma may contribute to the development of this rare autoimmune kidney disease in some patients.
    Language English
    Publishing date 2019-12-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2655800-2
    ISSN 2048-8513 ; 2048-8505
    ISSN (online) 2048-8513
    ISSN 2048-8505
    DOI 10.1093/ckj/sfz166
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Smoking-related glomerulopathy: expanding the morphologic spectrum.

    Salvatore, Steven P / Troxell, Megan L / Hecox, Douglas / Sperling, Kevin R / Seshan, Surya V

    American journal of nephrology

    2015  Volume 41, Issue 1, Page(s) 66–72

    Abstract: Background: Chronic smoking and hypertension may lead to smoking-related nodular glomerulopathy (SRNG), a well-recognized entity that clinically and pathologically mimics nodular diabetic nephropathy (DN). However, like DN, diffuse mesangial sclerosis ... ...

    Abstract Background: Chronic smoking and hypertension may lead to smoking-related nodular glomerulopathy (SRNG), a well-recognized entity that clinically and pathologically mimics nodular diabetic nephropathy (DN). However, like DN, diffuse mesangial sclerosis may occur in this setting without nodules.
    Methods: The clinicopathologic features of 10 non-diabetic patients with a long smoking history diagnosed from 2003-2012 showing diffuse mesangial glomerulosclerosis (6) or SRNG (4) were analyzed.
    Results: Nine of 10 patients were men, aged 58-80 with a 20-58 pack-year smoking history. None of the patients manifested diabetes, but all of them had hypertension. Numerous other cardiovascular comorbidities were present. At biopsy, the mean creatinine was 1.9 mg/dl (range 1.4-3) and the mean proteinuria was 3.9 g/24 h. The renal pathologic findings were similar in all patients except mesangial nodules in SRNG. Global glomerulosclerosis was seen in 6-72% of glomeruli (mean 31%), glomerulomegaly in all cases, and a range of interstitial fibrosis in 10-70% (mean 43%). Moderate (40%) and severe (50%) arteriosclerosis and arteriolar hyalinosis (80%) were also observed. Glomerular hilar or mesangial neovascularization was prominent. Endothelial swelling, subendothelial widening, and new basement membrane formation suggesting chronic healing thrombotic microangiopathy (TMA) was noted in 80%. No immune complexes were localized.
    Conclusions: Kidney biopsies from patients with proteinuria and chronic renal insufficiency in the setting of prolonged smoking and hypertension show either diffuse or nodular mesangial glomerulosclerosis. Chronic glomerular mesangial and endothelial injury associated with smoking leads to a chronic TMA appearance in the appropriate setting, even in the absence of mesangial nodule formation.
    MeSH term(s) Aged ; Aged, 80 and over ; Arterioles ; Arteriosclerosis/pathology ; Creatinine/blood ; Diarrhea/pathology ; Eye Diseases, Hereditary/pathology ; Female ; Fibrosis/pathology ; Glomerular Basement Membrane/pathology ; Glomerulosclerosis, Focal Segmental/pathology ; Humans ; Hypertension/complications ; Intestinal Diseases/pathology ; Male ; Middle Aged ; Neovascularization, Pathologic/pathology ; Nephrotic Syndrome/etiology ; Nephrotic Syndrome/pathology ; Proteinuria/urine ; Sclerosis/etiology ; Sclerosis/pathology ; Skin Abnormalities/pathology ; Smoking/adverse effects ; Thrombotic Microangiopathies/pathology ; Vascular Diseases/pathology
    Chemical Substances Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2015
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 604540-6
    ISSN 1421-9670 ; 0250-8095
    ISSN (online) 1421-9670
    ISSN 0250-8095
    DOI 10.1159/000371727
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A Diverse Spectrum of Immune Complex- and Complement-Mediated Kidney Diseases Is Associated With Mantle Cell Lymphoma.

    Andeen, Nicole K / Abdulameer, Shahad / Charu, Vivek / Zuckerman, Jonathan E / Troxell, Megan / Kambham, Neeraja / Alpers, Charles E / Najafian, Behzad / Nicosia, Roberto F / Smith, Kelly D / Kung, Vanderlene L / Avasare, Rupali S / Vallurupalli, Anusha / Jefferson, J Ashley / Hecox, Douglas / Swetnam, Leah / Yamashita, Michifumi / Lin, Mercury / Bissonnette, Mei Lin /
    Akilesh, Shreeram / Hou, Jean

    Kidney international reports

    2021  Volume 7, Issue 3, Page(s) 568–579

    Abstract: Introduction: There are limited reports on kidney biopsy findings in patients with mantle cell lymphoma (MCL).: Methods: We initiated a multi-institutional, retrospective review of kidney biopsy findings in patients with active and treated MCL.: ... ...

    Abstract Introduction: There are limited reports on kidney biopsy findings in patients with mantle cell lymphoma (MCL).
    Methods: We initiated a multi-institutional, retrospective review of kidney biopsy findings in patients with active and treated MCL.
    Results: A total of 30 patients with MCL and kidney biopsies were identified, with a median age of 67 (range 48-87) years, 73% of whom were men. A total of 20 patients had active MCL at the time of biopsy, of whom 14 (70%) presented with acute kidney injury (AKI), proteinuria and/or hematuria, and biopsy findings potentially attributable to lymphoma. Of the 14, 11 had immune complex (IC) or complement-mediated (C3) disease including proliferative glomerulonephritis (GN) with monotypic Ig deposits (PGNMID [2]), C3GN, (2), secondary membranous nephropathy (MN [3]), tubular basement membrane (TBM) deposits (2), and modest lupus-like GN (2). Lymphomatous infiltration was present in 8 of the 20 patients, 5 with coincident IC or C3 lesions. A total of 6 patients with available follow-up were treated for MCL, all with clinical remission of GN (2 PGNMID, 2 C3GN, and 2 MN).
    Conclusion: MCL is associated with diverse monoclonal and polyclonal glomerular and extra-glomerular IC and C3 disease. For patients with active MCL and kidney dysfunction requiring biopsy, 70% had findings due or potentially due to lymphoma, including 55% with IC or C3 disease and 40% had lymphomatous kidney infiltration. IC and C3GN in the setting of active MCL was responsive to lymphoma-directed therapy.
    Language English
    Publishing date 2021-12-27
    Publishing country United States
    Document type Journal Article
    ISSN 2468-0249
    ISSN (online) 2468-0249
    DOI 10.1016/j.ekir.2021.12.020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Smoking-Related Glomerulopathy: Expanding the Morphologic Spectrum

    Salvatore, Steven P. / Troxell, Megan L. / Hecox, Douglas / Sperling, Kevin R. / Seshan, Surya V.

    American Journal of Nephrology

    2015  Volume 41, Issue 1, Page(s) 66–72

    Abstract: Background: Chronic smoking and hypertension may lead to smoking-related nodular glomerulopathy (SRNG), a well-recognized entity that clinically and pathologically mimics nodular diabetic nephropathy (DN). However, like DN, diffuse mesangial sclerosis ... ...

    Institution Weill Cornell Medical College, New York, N.Y Oregon Health and Science University, Portland, Oreg Renal Care Consultants, Medford, Oreg., and Clinical Renal Associates Ltd., Upland, Pa., USA
    Abstract Background: Chronic smoking and hypertension may lead to smoking-related nodular glomerulopathy (SRNG), a well-recognized entity that clinically and pathologically mimics nodular diabetic nephropathy (DN). However, like DN, diffuse mesangial sclerosis may occur in this setting without nodules. Methods: The clinicopathologic features of 10 non-diabetic patients with a long smoking history diagnosed from 2003-2012 showing diffuse mesangial glomerulosclerosis (6) or SRNG (4) were analyzed. Results: Nine of 10 patients were men, aged 58-80 with a 20-58 pack-year smoking history. None of the patients manifested diabetes, but all of them had hypertension. Numerous other cardiovascular comorbidities were present. At biopsy, the mean creatinine was 1.9 mg/dl (range 1.4-3) and the mean proteinuria was 3.9 g/24 h. The renal pathologic findings were similar in all patients except mesangial nodules in SRNG. Global glomerulosclerosis was seen in 6-72% of glomeruli (mean 31%), glomerulomegaly in all cases, and a range of interstitial fibrosis in 10-70% (mean 43%). Moderate (40%) and severe (50%) arteriosclerosis and arteriolar hyalinosis (80%) were also observed. Glomerular hilar or mesangial neovascularization was prominent. Endothelial swelling, subendothelial widening, and new basement membrane formation suggesting chronic healing thrombotic microangiopathy (TMA) was noted in 80%. No immune complexes were localized. Conclusions: Kidney biopsies from patients with proteinuria and chronic renal insufficiency in the setting of prolonged smoking and hypertension show either diffuse or nodular mesangial glomerulosclerosis. Chronic glomerular mesangial and endothelial injury associated with smoking leads to a chronic TMA appearance in the appropriate setting, even in the absence of mesangial nodule formation.
    Keywords Smoking-related glomerulopathy ; Proteinuria ; Chronic kidney disease ; Idiopathic nodular glomerulopathy
    Language English
    Publishing date 2015-02-05
    Publisher S. Karger AG
    Publishing place Basel, Switzerland
    Document type Article
    Note Original Report: Patient-Oriented, Translational Research
    ZDB-ID 604540-6
    ISSN 1421-9670 ; 0250-8095
    ISSN (online) 1421-9670
    ISSN 0250-8095
    DOI 10.1159/000371727
    Database Karger publisher's database

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  5. Article ; Online: Antiviral immune response after live yellow fever vaccination of a kidney transplant recipient treated with IVIG.

    Slifka, Mark K / Hammarlund, Erika / Lewis, Matthew W / Poore, Elizabeth A / Hanifin, Jon M / Marr, Kieren A / Hecox, Douglas / Amanna, Ian J

    Transplantation

    2013  Volume 95, Issue 9, Page(s) e59–61

    MeSH term(s) Alanine Transaminase/blood ; Antibodies, Viral/blood ; Aspartate Aminotransferases/blood ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Kidney Transplantation ; Male ; Middle Aged ; Vaccination/adverse effects ; Yellow Fever Vaccine/adverse effects ; Yellow Fever Vaccine/immunology
    Chemical Substances Antibodies, Viral ; Immunoglobulins, Intravenous ; Yellow Fever Vaccine ; Aspartate Aminotransferases (EC 2.6.1.1) ; Alanine Transaminase (EC 2.6.1.2)
    Language English
    Publishing date 2013-05-04
    Publishing country United States
    Document type Case Reports ; Letter ; Research Support, N.I.H., Extramural
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0b013e31828c6d9e
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Central tolerance regulates B cells reactive with Goodpasture antigen alpha3(IV)NC1 collagen.

    Zhang, Ying / Su, Susan C / Hecox, Douglas B / Brady, Graham F / Mackin, Katherine M / Clark, Amy G / Foster, Mary H

    Journal of immunology (Baltimore, Md. : 1950)

    2009  Volume 181, Issue 9, Page(s) 6092–6100

    Abstract: Patients and rodents with Goodpasture's syndrome (GPS) develop severe autoimmune crescentic glomerulonephritis, kidney failure, and lung hemorrhage due to binding of pathogenic autoantibodies to the NC1 domain of the alpha3 chain of type IV collagen. ... ...

    Abstract Patients and rodents with Goodpasture's syndrome (GPS) develop severe autoimmune crescentic glomerulonephritis, kidney failure, and lung hemorrhage due to binding of pathogenic autoantibodies to the NC1 domain of the alpha3 chain of type IV collagen. Target epitopes are cryptic, normally hidden from circulating Abs by protein-protein interactions and the highly tissue-restricted expression of the alpha3(IV) collagen chain. Based on this limited Ag exposure, it has been suggested that target epitopes are not available as B cell tolerogens. To determine how pathogenic anti-GPS autoantibody responses are regulated, we generated an Ig transgenic (Tg) mouse model that expresses an Ig that binds alpha3(IV)NC1 collagen epitopes recognized by serum IgG of patients with GPS. Phenotypic analysis reveals B cell depletion and L chain editing in Tg mice. To determine the default tolerance phenotype in the absence of receptor editing and endogenous lymphocyte populations, we crossed Tg mice two generations with mice deficient in Rag. Resulting Tg Rag-deficient mice have central B cell deletion. Thus, development of Tg anti-alpha3(IV)NC1 collagen B cells is halted in the bone marrow, at which point the cells are deleted unless rescued by a Rag enzyme-dependent process, such as editing. The central tolerance phenotype implies that tolerizing self-Ag is expressed in bone marrow.
    MeSH term(s) Animals ; Anti-Glomerular Basement Membrane Disease/genetics ; Anti-Glomerular Basement Membrane Disease/immunology ; Antibodies, Monoclonal/metabolism ; Autoantibodies/biosynthesis ; Autoantibodies/physiology ; Autoantigens/immunology ; Autoantigens/metabolism ; B-Lymphocyte Subsets/immunology ; B-Lymphocyte Subsets/metabolism ; Cell Line, Tumor ; Collagen Type IV/immunology ; Collagen Type IV/metabolism ; Disease Models, Animal ; Homeodomain Proteins/genetics ; Humans ; Immune Tolerance/genetics ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Mice, Knockout ; Mice, Transgenic
    Chemical Substances Antibodies, Monoclonal ; Autoantibodies ; Autoantigens ; Collagen Type IV ; Homeodomain Proteins ; type IV collagen alpha3 chain ; RAG-1 protein (128559-51-3)
    Language English
    Publishing date 2009-01-08
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 3056-9
    ISSN 1550-6606 ; 0022-1767 ; 1048-3233 ; 1047-7381
    ISSN (online) 1550-6606
    ISSN 0022-1767 ; 1048-3233 ; 1047-7381
    DOI 10.4049/jimmunol.181.9.6092
    Database MEDical Literature Analysis and Retrieval System OnLINE

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