Light Chain Cast Nephropathy Presenting With Asymptomatic Proteinuria

Abstract

Kidney disease is a common complication of monoclonal gammopathies including multiple myeloma. Patients with multiple myeloma and other monoclonal gammopathies can present with a variety of kidney manifestations that depend upon the pathologic monoclonal proteins involved and the compartments of the kidney that are targeted. The most common clinical findings include acute or subacute kidney injury, chronic kidney disease (CKD) , albuminuria or nephrotic syndrome and electrolyte abnormalities. The spectrum of kidney impairment ranges from mild to severe acute kidney injury (AKI) requiring hemodialysis. Most patients presenting with AKI have light chain cast nephropathy. 58 year old female patient was referred to our clinic due to proteinuria. We aimed to represent a light chain cast nephropathy patient presenting with asymptomatic, non-nephrotic range proteinuria and whom were eventually treated with autologous stem cell transplantation. Light chain cast nephropathy should be kept in mind at the differantial diagnosis of patients presenting with asymptomatic non-nephrotic range proteinuria especially whom were treated with anti-proteinuric medications. Kidney biopsy should not be deferred during the diagnostic process.