Abstract
Two cases of multiple myeloma, presenting with light-chain tubulopathy
Highlights
Multiple myeloma (MM) is a plasma-cell dyscrasia presenting with generalized neoplastic changes in bones, accompanied by impaired haematopoiesis and susceptibility to infections
Hematological and organ remission after 4 courses of chemotherapy. In both cases typical clinical features of MM, like ossalgia, anemia, hypercalcemia and bone lytic lesions were absent, patients presented with kidney disease, and only kidney biopsy immunopathology study gave a clue to the diagnosis
Light-chain proximal tubulopathy is an infrequent variant of paraproteinemic kidney damage in patients mostly not demonstrating clinical features of multiple myeloma
Summary
Multiple myeloma (MM) is a plasma-cell dyscrasia presenting with generalized neoplastic changes in bones, accompanied by impaired haematopoiesis and susceptibility to infections. Bone marrow biopsy from March 2016 was re-evaluated: Iimmunohistochemistry with CD3, CD19, CD20, CD56, CD138, Cyclin D1, IgA, IgG, lambda and kappa light chains and was ordered and found large number of mature plasma cells CD138+, located interand para-trabecular discretely and in clusters up to 10 cells. These cells were kappa-positive and express CD56 (membrane reaction) and IgG (cytoplasmic reaction). Clinical diagnosis: Multiple myeloma IgG kappa and Bence-Jones kappa, light-chain tubulopathy with focal global glomerulosclerosis (CKD stage 3b), secondary immunodeficiency.
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