[IgG kappa myeloma with Fanconi's syndrome and crystalline inclusions. Immunohistochemical and ultrastructural study].
An IgG kappa light-chain myeloma, remarkable for the presence of inclusions in plasmocytes and proximal renal tubular cells, was discovered during investigations for renal failure associated with partial Fanconi's syndrome. An immunohistochemical study showed that the crystalline inclusions were positive for IgG and kappa light-chain in plasmocytes and exclusively for kappa light-chain in the renal tubular cells. An ultrastructural study showed that the inclusions were localized in lysosomes and had a 55 A periodicity. This case is similar to the forty odd myelomas or light-chain diseases reported in the literature and revealed by Fanconi's syndrome. Their prognosis is good, with a slow progression towards late renal failure. In our patient the preference of lesions for proximal tubular cells, the site of protein catabolism, was particular since in myelomas they are usually located in the distal tubular cells.
Service de Néphrologie-Hémodialyse, Centre hospitalier, Troyes.
F
F
Schillinger
C
C
Hopfner
R
R
Montagnac
T
T
Milcent
D000368:Aged; D005198:Fanconi Syndrome / Q000150:complications* / Q000473:pathology; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D007145:Immunoglobulin kappa-Chains; D007668:Kidney / Q000473:pathology / Q000648:ultrastructure; D008854:Microscopy, Electron; D010950:Plasma Cells / Q000473:pathology / Q000648:ultrastructure; D010954:Plasmacytoma / Q000150:complications* / Q000473:pathology / Q000648:ultrastructure
D007145:Immunoglobulin kappa-Chains
Myélome IgG kappa avec syndrome de Fanconi et inclusions cristallines. Etude immuno-histochimique et ultrastructurale.