• 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)
Orman SV, Schechter GP, Whang-Peng J, Guccion J, Chan C, Schulof RS, Shalhoub RJ. Nephrotic Syndrome Associated With a Clonal T-Cell Leukemia of Large Granular Lymphocytes With Cytotoxic Function. Arch Intern Med. 1986;146(9):1827-1829. doi:10.1001/archinte.1986.00360210223034