Multiple Myeloma Presented as Tubulointerstitial Nephritis / 대한신장학회지

ABSTRACT

Renal damage in patients with myeloma is one of the most important causes of acute renal failure. Although cast nephropathy characterized by cast formation in the distal nephron is the main renal lesion, a diverse spectrum of renal lesions can be observed in patients with myeloma. A 48-year-old woman was admitted to our hospital because of acute renal failure. The patient had been well until a few weeks earlier, when she experienced severe headaches. During the next week, she began to have general ache, became increasingly irritable, and began to have pain on both lower legs. After admission, her serum creatinine had increased up to 4.02 mg/dL, her anemia was more aggravated, and her 24 hour urine protein was 2.4 g. She had a monoclonal spike in her urine protein elctrophoresis. Her bone marrow was infiltrated by over 30% plasma cells, so she received hemodialysis and chemotherapy.