Acanthocytes and proteinuria in a 47-year-old male

We report the case of a 47-year old male patient who presented in our nephrological outpatient unit with acute prostatitis with increased serum creatinine levels and macrohematuria following repeated successful antibiotic treatments for prostatitis. The patient was able-bodied and capable of reporting that he had taken no medication other than the antibiotic medication prescribed. Initial findings of classic nephritic sediment, significant proteinuria and the onset of acute kidney failure lead to the suspicion of nephritic syndrome, which was not confirmed by an otherwise inconclusive biopsy. A diagnosis was reached only after bone marrow biopsy and later findings from the renal biopsy: isolated vascular light chain nephropathy and marginal zone B-cell lymphoma with plasma cell differentiation, the causes of which remain unclear. Following initial steroid and antibiotic treatment the patient received further oncological treatment according to the R-CHOP protocol. © 2008 Springer-Verlag.