Concomitant Nephrotic Syndrome and Cryoglobulinemia in a Case of Malignant Mesothelioma

Figure 1

The clinical course of the patient. Two years earlier, the patient had been diagnosed with malignant mesothelioma by lung biopsy and treated with chemotherapy. Cisplatin plus pemetrexed (CDDP + PEM) and carboplatin plus pemetrexed (CBDCA + PEM) were determined to result in an insufficient response, and nivolumab was considered to have induced immune-related adverse events and was discontinued. After starting the administration of gemcitabine (GEM), drug-induced lung injury occurred. He was also referred to a nephrologist because of the subsequent development of edema, renal injury, and proteinuria. After investigations and careful consideration, vinorelbine (VNR) was administered to treat the nephrotic syndrome with cryoglobulinemia due to the progression of malignant mesothelioma. Response of chemotherapy to malignant mesothelioma is presented as partial response (PR), stable disease (SD), and progressive disease (PD). Palliative care was subsequently provided, along with radiation therapy for metastatic bone lesions and antibiotics against bacterial pneumonia. The patient died a little over 3 years after the pathological diagnosis of mesothelioma without recurrence of nephrotic syndrome in the end-stage of cancer.