Mixed type II cryoglobulinemiaassociated glomerulonephritis revealing an extragastric marginal zone lymphoma in the absence of viral infection: A rare case report from Bourges Hospital
Mansour, Belkacem
Mixed type II cryoglobulinemiaassociated glomerulonephritis revealing an extragastric marginal zone lymphoma in the absence of viral infection: A rare case report from Bourges Hospital - 2025.
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Introduction. Type II mixed cryoglobulinemia is most commonly associated with chronic hepatitis C virus infection. The occurrence of marginal zone lymphoma as the underlying cause is rare, especially in the absence of gastric involvement. Case report. A 63-year-old woman with hypertension and hypothyroidism initially presented with transient purpura following a urinary tract infection. Two months later, she developed acute kidney injury, proteinuria (2.3 g/24 h), and microscopic hematuria. Laboratory tests showed type II mixed cryoglobulinemia (IgM κ + IgG) with hypocomplementemia. Viral serologies, including HCV, were negative. Renal biopsy revealed membranoproliferative glomerulonephritis with IgM and IgG deposits. Blood and bone marrow immunophenotyping confirmed an extragastric marginal zone lymphoma. The patient was treated with six cycles of rituximab-bendamustine. Results. Complete remission was achieved: recovery of renal function (creatinine 84 μmol/L at 12 months), resolution of proteinuria, improvement of anemia, and regression of splenomegaly. No relapse was observed after 18 months of follow-up. Discussion/Conclusion. This case represents a particularly rare presentation of type II mixed cryoglobulinemia revealing an extragastric marginal zone lymphoma in the absence of viral infection or gastric involvement. It contributes to the sparse literature on this uncommon association. Treatment with rituximab-bendamustine appears to be effective.
Mixed type II cryoglobulinemiaassociated glomerulonephritis revealing an extragastric marginal zone lymphoma in the absence of viral infection: A rare case report from Bourges Hospital - 2025.
34
Introduction. Type II mixed cryoglobulinemia is most commonly associated with chronic hepatitis C virus infection. The occurrence of marginal zone lymphoma as the underlying cause is rare, especially in the absence of gastric involvement. Case report. A 63-year-old woman with hypertension and hypothyroidism initially presented with transient purpura following a urinary tract infection. Two months later, she developed acute kidney injury, proteinuria (2.3 g/24 h), and microscopic hematuria. Laboratory tests showed type II mixed cryoglobulinemia (IgM κ + IgG) with hypocomplementemia. Viral serologies, including HCV, were negative. Renal biopsy revealed membranoproliferative glomerulonephritis with IgM and IgG deposits. Blood and bone marrow immunophenotyping confirmed an extragastric marginal zone lymphoma. The patient was treated with six cycles of rituximab-bendamustine. Results. Complete remission was achieved: recovery of renal function (creatinine 84 μmol/L at 12 months), resolution of proteinuria, improvement of anemia, and regression of splenomegaly. No relapse was observed after 18 months of follow-up. Discussion/Conclusion. This case represents a particularly rare presentation of type II mixed cryoglobulinemia revealing an extragastric marginal zone lymphoma in the absence of viral infection or gastric involvement. It contributes to the sparse literature on this uncommon association. Treatment with rituximab-bendamustine appears to be effective.
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