Disappearance of nodular mesangial lesions in a patient with light chain nephropathy after long-term chemotherapy.
A 64-year-old man developed multiple myeloma (kappa light chain type), nephrotic syndrome, and renal insufficiency in 1993. A renal biopsy showed typical histological findings of light chain nephropathy: nodular glomerulosclerosis with deposition of kappa light chains in the mesangial area and subendothelial space of the glomerular capillary walls. Long-term intermittent MEVP chemotherapy (melphalan, 4 mg/d for 4 days; cyclophosphamide, 100 mg/d for 4 days; vincristine, 1 mg/d; prednisolone, 40 mg/d for 4 days) diminished proteinuria and improved renal function. In April 1999, a follow-up biopsy showed remarkable diminution of nodular lesions and disappearance of kappa light chain deposits. Although the prognosis of light chain nephropathy has been considered poor, long-term successful chemotherapy can clear light chain deposits and restore renal function.
Komatsuda
A
A
Third Department of Internal Medicine, Akita University School of Medicine, and the Department of Internal Medicine, Yamamoto General Hospital, Akita, Japan. komatsud@med.akita-u.ac.jp
Wakui
H
H
Ohtani
H
H
Kodama
T
T
Miki
K
K
Imai
H
H
Miura
A B
AB
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005920:Glomerular Mesangium / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007147:Immunoglobulin Light Chains; D007145:Immunoglobulin kappa-Chains / Q000032:analysis*; D007674:Kidney Diseases / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy / Q000276:immunology
D007147:Immunoglobulin Light Chains; D007145:Immunoglobulin kappa-Chains