Table 1 Main laboratory work-up, imaging and histology studies from 2004 to 2012
Year | Investigations | Results |
|---|---|---|
2004 | Laboratory Work-up | |
Blood tests | Serum creatinine: 3.51 mg/dL, eGFR: 24 ml/min/1.73 m2, low serum C3 and C4 levels, hypergammaglobulinemia (4590 mg/dL), hypoalbuminemia, negative ANA. | |
Urine tests | Proteinuria (13800 mg/l). | |
Imaging studies | ||
Kidney ultrasound | Diffuse kidney enlargement. | |
Abdominal MRI | Infracentimetric lombo-aortic lymphadenopathies and kidney enlargement. | |
PET/CT | Sub and super diaphragmatic hypermetabolic lymphadenopathies compatible with lymphoproliferative disorder associated with heterogeneous fixation in kidneys. | |
Whole skeleton X-Ray | No lesion. | |
Histology studies | ||
Bone marrow biopsy | Suspicion of myelodysplastic syndrome. | |
Lymph node biopsy | Reactive lymphoid hyperplasia. | |
Renal biopsy | MGN with IgG and C3d deposits associated with severe TIN and lymphoplasmocytic infiltrate. | |
2005 | Histology studies | |
Skin biopsy | IgG and C3d deposits. | |
2008 | Laboratory Work-up | |
Blood tests | Serum creatinine: 1.55 mg/dL, eGFR: 51 ml/min/1.73 m2, low serum C3 and C4 levels, hypergammaglobulinemia (3460 mg/dl), ANA (1/80) characterized as anti-dsDNA, thrombocytopenia. | |
Urine tests | Proteinuria (6081 g/l). | |
Imaging studies | ||
Abdominal CT | Iliac and aortic supra-centimetric lymphadenopathies. | |
PET/CT | Sub and super diaphragmatic hypermetabolic lymphadenopathies in progression compared to 2004. | |
Whole skeleton X-Ray | No lesion. | |
Histology studies | ||
Bone marrow biopsy | Reactive lymphoid hyperplasia of bone marrow. | |
Lymph node biopsy | Reactive lymphoid hyperplasia. | |
Renal biopsy | MGN with IgG and C3d deposits associated with chronic interstitial nephropathy (mononuclear infiltrate) without clear sign of tubular involvement. | |
2012 | Laboratory Work-up | |
Blood tests | Serum creatinine: 1.6 mg/dL, eGFR: 48 ml/min/1.73 m2, low serum C3 and C4 levels, hypergammaglobulinemia (4250 mg/dL) with oligoclonal banding, ANA (1/640), Anti-dsDNA negative, IgG4 (2790 mg/dL), negative PLA2R antibodies test. | |
Urine tests | Proteinuria (444 mg/l). | |
Imaging studies | ||
Thoraco-abdominal CT | Sub and super diaphragmatic supracentimetric lymphadenopathies. | |
PET/CT | Sub and super diaphragmatic hypermetabolic lymphadenopathies in progression compared to 2008. | |
Histology studies | ||
Lymph node biopsy | IgG4-related lymphadenopathy (IgG4+/IgG+ cells > 40% and >10 IgG4+ plasma cells per HPF). | |