POS-026 DEPOSIT DENSE DISEASE (DDD), MONOCLONAL GAMMOPATHY in a 20 y.o. WOMAN USING KETOPROPHEN

Abstract

IntroductionThree years daily use of ketoprophen due to dysmenorrhea-pelvic pain, after 2 m.os drug suspension proteinuria 4g/day didn’t quit, MCD or MGN connected with nSAID abuse was suspected. Four years before hypercholesterolemia was already present.Father affected from Behcet syndrome.During a 8 m.os follow up a monoclonal gammopathy, low C3 (26 mg/dl, n.v. 80-180) and IgG levels (306 mg/dl n.v.700-1600) were detected, C4 levels being 22 mg/dl (n.v. 10-40). Proteinuria raised to 8g /day, Total proteins 4.1 g/dl, Creatinine Clearance 166 ml/min’. Ketoprophen more than 6 mo.s use was associated in women 50-59 y.o. with monoclonal gammopathy, 0.07 % in a series of 11300 users that suffered of side effects during treatment.MethodsIgG and C3 low levels on two subsequent exams, hematuria and hyaline-granular casts made us decide for renal biopsy (RB).ResultsConclusionsWork up on complement in the patient and her father, particularly on factor H polymorphism e.g. rs800292 SNP correlated with clinical activity in Behcet disease is advisable.Monoclonal gammopathy intensive investigation for clonal therapy is deserved for a may be gammopathy of renal significance.A possible overlap between genetic and acquired complement dysfunction is possibleNo conflict of interest IntroductionThree years daily use of ketoprophen due to dysmenorrhea-pelvic pain, after 2 m.os drug suspension proteinuria 4g/day didn’t quit, MCD or MGN connected with nSAID abuse was suspected. Four years before hypercholesterolemia was already present.Father affected from Behcet syndrome.During a 8 m.os follow up a monoclonal gammopathy, low C3 (26 mg/dl, n.v. 80-180) and IgG levels (306 mg/dl n.v.700-1600) were detected, C4 levels being 22 mg/dl (n.v. 10-40). Proteinuria raised to 8g /day, Total proteins 4.1 g/dl, Creatinine Clearance 166 ml/min’. Ketoprophen more than 6 mo.s use was associated in women 50-59 y.o. with monoclonal gammopathy, 0.07 % in a series of 11300 users that suffered of side effects during treatment. Three years daily use of ketoprophen due to dysmenorrhea-pelvic pain, after 2 m.os drug suspension proteinuria 4g/day didn’t quit, MCD or MGN connected with nSAID abuse was suspected. Four years before hypercholesterolemia was already present. Father affected from Behcet syndrome. During a 8 m.os follow up a monoclonal gammopathy, low C3 (26 mg/dl, n.v. 80-180) and IgG levels (306 mg/dl n.v.700-1600) were detected, C4 levels being 22 mg/dl (n.v. 10-40). Proteinuria raised to 8g /day, Total proteins 4.1 g/dl, Creatinine Clearance 166 ml/min’. Ketoprophen more than 6 mo.s use was associated in women 50-59 y.o. with monoclonal gammopathy, 0.07 % in a series of 11300 users that suffered of side effects during treatment. MethodsIgG and C3 low levels on two subsequent exams, hematuria and hyaline-granular casts made us decide for renal biopsy (RB). IgG and C3 low levels on two subsequent exams, hematuria and hyaline-granular casts made us decide for renal biopsy (RB). Results ConclusionsWork up on complement in the patient and her father, particularly on factor H polymorphism e.g. rs800292 SNP correlated with clinical activity in Behcet disease is advisable.Monoclonal gammopathy intensive investigation for clonal therapy is deserved for a may be gammopathy of renal significance.A possible overlap between genetic and acquired complement dysfunction is possibleNo conflict of interest Work up on complement in the patient and her father, particularly on factor H polymorphism e.g. rs800292 SNP correlated with clinical activity in Behcet disease is advisable.