Waldenstrom’s Macroglobulinemia: A Report of Two Cases, One with Severe Retinopathy and One with Renal Failure
Table 1
Clinical features and laboratory data.
Case 1
Case 2
Age (yrs)/gender
63/F
58/M
Chief complaints
Lightheadedness
Nausea
Drowsiness
Dysgeusia
Blurred vision
Oliguria
Major clinical features
Retinopathy (group 3)
Renal failure (group 3)
Laboratory data on admission
WBC (/µL)
6,900
8,200
Hb (g/dL)
7.9
8.2
Platelet counts (/µL)
124,000
107,000
PB smear
Rouleaux formation
Rouleaux formation
CRP (mg/dL)
0.19
1.15
LDH (U/L)
174
102
Total protein (g/dL)
9.2
9.3
Albumin (g/dL)
2.1
3.2
Serum BUN (mg/dL)
20.9
124.4
Creatinine (mg/dL)
1.25
11.1
Na (mmol/L)
135
137
K (mmol/L)
4.3
7.6
Cl (mmol/L)
98
112
IgG (mg/dL)
427
473
IgA (mg/dL)
137
20
IgM (mg/dL)
6,080
3,603
Beta-2-MG (mg/dL)
4.0
36.5
sIL-2R (U/L)
767
NT
Monoclonal protein
IgM-kappa
IgM-kappa
Proteinuria
2+
2+
MYD88
NT
NT
Treatment
Initial management and chemotherapy induction
DFPP/PE/rituximab/2-CDA
Hemodialysis
Rituximab/bendamustine
Maintenance
Rituximab/thalidomide
None
Outcome
Alive (yrs)
8+
0.5
Defined by Menke et al. [14]; defined by Chauvet et al. [21], Vos et al. [11], and Audard et al. [20]; died of severe pneumonia after the sixth cycle of rituximab/bendamustine. NT = not tested, MYD88 = myeloid differentiation 88, DFPP = double-filtration plasmapheresis, PE = plasma exchange, 2-CDA = 2-chloro-2′-deoxyadenosine.