Acute renal failure secondary to severe type I cryoglobulinemia following rituximab therapy for Waldenström's macroglobulinemia

Aisha Shaikh, Thomas M. Habermann, Mary E. Fidler, Shaji Kumar, Nelson Leung

Research output: Contribution to journalArticle

13 Scopus citations


Waldenström's macroglobulinemia is rare lymphoproliferative disorder characterized by the presence of a monoclonal IgM paraproteinemia. Cryoglobulinemia is a common sequela of Waldenström's macroglobulinemia present in 8-18% of the patients. Cryoglobulinemia has also been described as occurring after treatment with rituximab. In the previous report, the cryoglobulinemia was a transient phenomenon and did not carry any adverse effect. We present a case of an 80-year-old male with Waldenström's macroglobulinemia in whom the rituximab-induced cryoglobulinemia resulted in acute renal failure and a vasculitic rash. Cryoglobulins level reached a peak of 63%. The patient was successfully treated with plasmapheresis, chlorambucil and prednisone, with near-complete recovery of renal function. As this case illustrates, the rituximab-induced cryoglobulin is not always benign. Pre- and post-treatment monitoring of the cryoglobulin level is advised in these patients.

Original languageEnglish (US)
Pages (from-to)292-295
Number of pages4
JournalClinical and Experimental Nephrology
Issue number4
StatePublished - Aug 1 2008



  • Acute renal failure
  • Cryoglobulinemia
  • Rituximab
  • Waldenström's macroglobulinemia

ASJC Scopus subject areas

  • Physiology
  • Nephrology
  • Physiology (medical)

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