title: Disappearance of nodular mesangial lesions in a patient with light chain nephropathy after long-term chemotherapy.
abstract: 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.
authors.affiliation: 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
authors.forename: A
authors.initials: A
authors.lastname: Komatsuda
authors.forename: H
authors.initials: H
authors.lastname: Wakui
authors.forename: H
authors.initials: H
authors.lastname: Ohtani
authors.forename: T
authors.initials: T
authors.lastname: Kodama
authors.forename: K
authors.initials: K
authors.lastname: Miki
authors.forename: H
authors.initials: H
authors.lastname: Imai
authors.forename: A B
authors.initials: AB
authors.lastname: Miura
mesh_terms: 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
chemical_list: D007147:Immunoglobulin Light Chains; D007145:Immunoglobulin kappa-Chains