Waldenström's macroglobulinaemia presenting with nephrotic syndrome.

Minimal change nephropathy (MCN) is a major cause of nephrotic syndrome in both children and adults. It is characterised by normal appearing glomeruli by light microscopy and the absence of immunoglobulin deposits by immunoflorescence microscopy. On electron microscopy there is diffuse fusion of the epithelial foot processes. MCN is suggested to be caused by a T-cell or B-cell dysfunction and/or a yet undefined circulating glomerular permeability factor. Most cases of MCN are idiopathic, but sometimes MCN seems to be associated with an underlying cause such as drugs, neoplasms, atopy, other glomerular diseases or infection. Here we describe a case of a 55-year-old male who was diagnosed with a nephrotic syndrome caused by MCN, which seems to be associated with Waldenström’s macroglobulinaemia. Treatment not only resulted in complete remission of the Waldenström’s macroglobulinaemia but also in complete remission of the nephrotic syndrome.