Coexistence of myeloma cast nephropathy, light chain deposition disease, and nonamyloid fibrils in a patient with multiple myeloma

Qi Qian, Nelson Leung, Jason D. Theis, Ahmet Dogan, Sanjeev M Sethi

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Plasma cell dyscrasias can present as myeloma cast nephropathy, AL amyloid, or light chain deposition disease. We describe the unusual kidney biopsy findings of concurrent myeloma cast nephropathy and glomerular nonamyloid fibrillary deposits composed of immunoglobulin G (IgG) heavy chains and λ light chains in a patient with multiple myeloma who presented with acute renal failure. We performed laser microdissection and mass spectrometrybased proteomic analysis, which showed that the fibrillary deposits likely contained Igγ1 constant region and λ light chain constant region, whereas κ light chains and serum amyloid P proteins were absent. Treatment of multiple myeloma resulted in resolution of the renal manifestations, suggesting a common underlying mechanism for the cast nephropathy and heavy and light chain deposition disease. We show that laser microdissection and mass spectrometry is an extremely useful ancillary test for the diagnosis of heavy and light chain deposition diseases.

Original languageEnglish (US)
Pages (from-to)971-976
Number of pages6
JournalAmerican Journal of Kidney Diseases
Volume56
Issue number5
DOIs
StatePublished - Nov 2010

Fingerprint

Multiple Myeloma
Light
Microdissection
Lasers
Amyloidogenic Proteins
Kidney
Immunoglobulin Heavy Chains
Paraproteinemias
Acute Kidney Injury
Amyloid
Proteomics
Blood Proteins
Mass Spectrometry
Immunoglobulin G
Biopsy

Keywords

  • cast nephropathy
  • Heavy and light chain deposition disease
  • Index Words
  • laser microdissection
  • mass spectrometry
  • multiple myeloma
  • proteomics

ASJC Scopus subject areas

  • Nephrology
  • Medicine(all)

Cite this

Coexistence of myeloma cast nephropathy, light chain deposition disease, and nonamyloid fibrils in a patient with multiple myeloma. / Qian, Qi; Leung, Nelson; Theis, Jason D.; Dogan, Ahmet; Sethi, Sanjeev M.

In: American Journal of Kidney Diseases, Vol. 56, No. 5, 11.2010, p. 971-976.

Research output: Contribution to journalArticle

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