[Renal insufficiency due to light chain multiple myeloma].
In 3 female patients, aged 65, 83 and 76 years, with severe renal failure, light chain multiple myeloma was diagnosed, following a substantial delay on the part of the doctors concerned. Either the diagnosis had not suspected or the serum proteins had been misinterpreted. After a while, the first two patients declined further treatment with chemotherapy and haemodialysis, and subsequently died. The third patient attained a creatinine clearance of 20 ml/min and was subsequently treated for the multiple myeloma in the outpatients department. The absence of a paraprotein peak in the serum does not exclude the possibility of a multiple myeloma. In the case of light chain disease, the gammaglobulin region is, in fact, often empty. Treatment of multiple myeloma consists of a rapid rehydration and forced diuresis; the usefulness of plasmapheresis has not been demonstrated.
van Zaanen
H C
HC
Sint Franciscus Gasthuis, afd. Inwendige Geneeskunde, Rotterdam.
Diderich
P P
PP
Pegels
J G
JG
Ruizeveld de Winter
J A
JA
D058186:Acute Kidney Injury / Q000209:etiology* / Q000503:physiopathology; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001536:Bence Jones Protein / Q000652:urine*; D001706:Biopsy; D003404:Creatinine / Q000652:urine; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology*; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy / Q000652:urine; D009194:Myeloma Proteins / Q000378:metabolism*; D009846:Oliguria / Q000209:etiology; D011379:Prognosis; D011507:Proteinuria / Q000209:etiology; D016896:Treatment Outcome; D005719:gamma-Globulins / Q000378:metabolism*
D009194:Myeloma Proteins; D005719:gamma-Globulins; D001536:Bence Jones Protein; D003404:Creatinine