Five Sequential Evaluations of Renal Histology in a Patient with Light Chain Deposition Disease

A 58-year-old man was referred to our institution for an evaluation of nephrotic range proteinuria. Renal biopsy showed a marked expansion of the mesangial matrix and thickening of glomerular basement membrane (GBM) in periodic acid-silver methenamine (PAM). Immunofluorescence (IF) revealed strong s...

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Autores principales: Ueno, Toshiharu, Kikuchi, Koichi, Hazue, Ryo, Mise, Koki, Sumida, Keiichi, Hayami, Noriko, Suwabe, Tatsuya, Hoshino, Junichi, Sawa, Naoki, Arizono, Kenji, Hara, Shigeko, Takaichi, Kenmei, Fujii, Takeshi, Ohashi, Kenichi, Ubara, Yoshifumi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2016
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5109568/
https://www.ncbi.nlm.nih.gov/pubmed/27746438
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author Ueno, Toshiharu
Kikuchi, Koichi
Hazue, Ryo
Mise, Koki
Sumida, Keiichi
Hayami, Noriko
Suwabe, Tatsuya
Hoshino, Junichi
Sawa, Naoki
Arizono, Kenji
Hara, Shigeko
Takaichi, Kenmei
Fujii, Takeshi
Ohashi, Kenichi
Ubara, Yoshifumi
author_facet Ueno, Toshiharu
Kikuchi, Koichi
Hazue, Ryo
Mise, Koki
Sumida, Keiichi
Hayami, Noriko
Suwabe, Tatsuya
Hoshino, Junichi
Sawa, Naoki
Arizono, Kenji
Hara, Shigeko
Takaichi, Kenmei
Fujii, Takeshi
Ohashi, Kenichi
Ubara, Yoshifumi
author_sort Ueno, Toshiharu
collection PubMed
description A 58-year-old man was referred to our institution for an evaluation of nephrotic range proteinuria. Renal biopsy showed a marked expansion of the mesangial matrix and thickening of glomerular basement membrane (GBM) in periodic acid-silver methenamine (PAM). Immunofluorescence (IF) revealed strong staining for the monoclonal kappa light chain. EM demonstrated massive subendothelial and mesangial dense deposits. As a result, light chain deposition disease (LCDD) was diagnosed. Melphalan and prednisolone (MP) therapy was started, which was continued for 10 years with minimal complications. Serial evaluations of renal histology revealed the resolution of nodular lesions and the glomeruli became nearly normal. MP therapy can therefore be an effective therapeutic option for LCDD if it is continued over the long term.
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spelling pubmed-51095682016-11-17 Five Sequential Evaluations of Renal Histology in a Patient with Light Chain Deposition Disease Ueno, Toshiharu Kikuchi, Koichi Hazue, Ryo Mise, Koki Sumida, Keiichi Hayami, Noriko Suwabe, Tatsuya Hoshino, Junichi Sawa, Naoki Arizono, Kenji Hara, Shigeko Takaichi, Kenmei Fujii, Takeshi Ohashi, Kenichi Ubara, Yoshifumi Intern Med Case Report A 58-year-old man was referred to our institution for an evaluation of nephrotic range proteinuria. Renal biopsy showed a marked expansion of the mesangial matrix and thickening of glomerular basement membrane (GBM) in periodic acid-silver methenamine (PAM). Immunofluorescence (IF) revealed strong staining for the monoclonal kappa light chain. EM demonstrated massive subendothelial and mesangial dense deposits. As a result, light chain deposition disease (LCDD) was diagnosed. Melphalan and prednisolone (MP) therapy was started, which was continued for 10 years with minimal complications. Serial evaluations of renal histology revealed the resolution of nodular lesions and the glomeruli became nearly normal. MP therapy can therefore be an effective therapeutic option for LCDD if it is continued over the long term. The Japanese Society of Internal Medicine 2016-10-15 /pmc/articles/PMC5109568/ /pubmed/27746438 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Ueno, Toshiharu
Kikuchi, Koichi
Hazue, Ryo
Mise, Koki
Sumida, Keiichi
Hayami, Noriko
Suwabe, Tatsuya
Hoshino, Junichi
Sawa, Naoki
Arizono, Kenji
Hara, Shigeko
Takaichi, Kenmei
Fujii, Takeshi
Ohashi, Kenichi
Ubara, Yoshifumi
Five Sequential Evaluations of Renal Histology in a Patient with Light Chain Deposition Disease
title Five Sequential Evaluations of Renal Histology in a Patient with Light Chain Deposition Disease
title_full Five Sequential Evaluations of Renal Histology in a Patient with Light Chain Deposition Disease
title_fullStr Five Sequential Evaluations of Renal Histology in a Patient with Light Chain Deposition Disease
title_full_unstemmed Five Sequential Evaluations of Renal Histology in a Patient with Light Chain Deposition Disease
title_short Five Sequential Evaluations of Renal Histology in a Patient with Light Chain Deposition Disease
title_sort five sequential evaluations of renal histology in a patient with light chain deposition disease
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5109568/
https://www.ncbi.nlm.nih.gov/pubmed/27746438
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