Multiple Myeloma Presenting as Acute Kidney Failure Secondary to Lambda Light Chain Deposition
DOI:
https://doi.org/10.12974/2312-5411.2022.09.03Keywords:
Monoclonal immunoglobulin deposition disease, Light chain and heavy chain deposition disease, Plasma cell neoplasms, Light chain deposition disease, Multiple myeloma, Randall disease, Kidney failureAbstract
Renal monoclonal immunoglobulin deposition disease (MIDD) is a rare disease defined by deposition of monoclonal light chains and/or heavy chains on basement membranes and vascular walls of the kidney. We describe a case of a 71-year-old woman with kidney failure secondary to monoclonal immunoglobulin deposition disease lambda in association with plasma cell dyscrasia. Her initial serum protein electrophoresis did not demonstrate a monoclonal protein, and classic cast nephropathy was absent on renal biopsy. However, lambda light chain deposits and associated changes confirmed MIDD. She achieved a very good partial response (VGRP) after 8 cycles of CyBorD (cyclophosphamide, bortezomib, dexamethasone) and her kidney function improved. This case highlights the importance of an early diagnostic with renal biopsy to prevent end-stage renal disease. A review of the existing literature and a discussion on the management of the disease is presented.
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