Multiple myeloma presenting as acute tubulointerstitial nephritis
Autops. Case Rep
;
11: e2021328, 2021. graf
Artículo
en Inglés
| LILACS
| ID: biblio-1339243
ABSTRACT
Background Acute tubulointerstitial nephritis (ATIN) is a very rare paraneoplastic manifestation in patients with multiple myeloma (MM). It is an uncommon pattern of renal disease in such patients. Case presentation We report a case of an 82-year-old male who was admitted with acute kidney injury. Renal biopsy showed typical findings of light chain-associated ATIN with scattered inflammatory cells in the interstitium and associated active tubulitis. No other common manifestations of MM were present at the time of presentation, including hypercalcemia, hyperuricemia, proteinuria, bone pain or lytic bone lesions. Subsequent immunoassays revealed significant serum lambda light chain burden and Bence Jones protein in urine. Immunofluorescence demonstrated linear tubular basement membranes with positive staining for lambda light chain (3+). Electron microscopy (EM) further showed interstitial edema and inflammation. All the aforementioned findings are consistent with ATIN and supported the diagnosis of MM. Conclusions In conclusion, light chain-associated ATIN should be considered in the differential diagnosis of acute interstitial nephritis. Henceforth, serum free light chains as well as serum and urine protein electrophoresis should be included in the workup of such patients.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Mieloma Múltiple
/
Nefritis Intersticial
Tipo de estudio:
Estudio diagnóstico
Límite:
Anciano
/
Aged80
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Autops. Case Rep
Asunto de la revista:
Anatomia
/
Patologia Cl¡nica
/
Patologia Legal
Año:
2021
Tipo del documento:
Artículo
País de afiliación:
Estados Unidos
Institución/País de afiliación:
Louisiana State University Health/US
/
Mount Sinai Medical Center/US
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