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Nephrotic Syndrome Associated With a Clonal T-Cell Leukemia of Large Granular Lymphocytes With Cytotoxic Function

Stephen V. Orman, MD; Geraldine P. Schechter, MD; Jacqueline Whang-Peng, MD; John Guccion, MD; Clara Chan, MD; Richard S. Schulof, MD; Robert J. Shalhoub, MD
Arch Intern Med. 1986;146(9):1827-1829. doi:10.1001/archinte.1986.00360210223034.
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• A 51-year-old man presented with a T-cell leukemia of large granular lymphocytes and rapidly developed a nephrotic syndrome due to presumptive minimal-change glomerulopathy. The E-rosette+, la+ cells demonstrated cytotoxic activity similar to that of natural killer lymphocytes but lacked other T-subset markers, except that one third of them bore Fc(IgG) receptors. Cytogenetic analysis revealed loss of chromosome 10 and the translocation (1;10)(p11;q11) in all metaphases. Regression of the leukemia after chemotherapy was accompanied by a dramatic resolution of the nephrotic syndrome, suggesting that the activated granular lymphocytes induced the renal lesion. The close association of a clonal T-lymphoproliferative disorder with minimal-change nephrotic syndrome lends further support to current views implicating activated T cells or their products in the pathogenesis of this glomerulopathy.

(Arch Intern Med 1986;146:1827-1829)


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