title: Acute renal failure following intravenous pyelography (IVP) in a patient with diffuse hypergammaglobulinemia: a case report.
abstract: A 65-year-old woman with polyclonal hypergammaglobulinemia developed acute renal failure requiring hemodialysis after an intravenous pyelogram (IVP). An increased risk of renal injury after IVP for patients with polyclonal hypergammaglobulinemia has not been previously recognized, although a parallel risk to patients with myeloma has been well established. At autopsy, immunoperoxidase staining of the bone marrow demonstrated plasma cell subpopulations with intracellular staining for IgG, IgA, and IgM and chi and lambda light chains, proving that this patient did not have occult myeloma. Immunoperoxidase staining of casts in renal tubules also demonstrated polyclonal immunoglobulins.
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006942:Hypergammaglobulinemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000276:immunology; D007124:Immunoenzyme Techniques; D007684:Kidney Tubules / Q000276:immunology / Q000473:pathology; D008207:Lymphatic Metastasis; D010051:Ovarian Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging; D006435:Renal Dialysis; D012306:Risk; D014567:Urography / Q000009:adverse effects
chemical_list: D003287:Contrast Media