Henoch-Schönlein IgA glomerulonephritis complicating myeloma kidneys: case report.
Myeloma kidney is the principal pathological substrate of rapidly progressive renal failure in multiple myeloma. We report the unusual case of a 72-year-old male diagnosed with kappa Bence Jones myeloma with renal failure which needed dialysis. After treatment with vincristine, doxorubicin (Adriamycin), dexamethasone (VAD), and plasmapheresis, the renal function was recovered until serum creatinine level was <2 mg/dl. Six months later, the pathological counterpart of rapidly progressive renal failure was crescentic IgA proliferative glomerulonephritis as a manifestation of Henoch-Schönlein syndrome associated with sepsis caused by coagulase-negative staphylococci. This case suggests that mesangial IgA deposition should be considered within the spectrum of consequent glomerular lesion-associated chemotherapy occurring in multiple myeloma.
Arrizabalaga
P
P
Service of Nephrology, Hospital Clínic, Biomedical Investigation Institute August Pi i Sunyer, c/ Villarroel 170, 08036, Barcelona, Spain. parriza@clinic.ub.es.
Saurina
A
A
Service of Nephrology, Hospital Clínic, Biomedical Investigation Institute August Pi i Sunyer, c/ Villarroel 170, 08036, Barcelona, Spain.
Solé
M
M
Service of Pathology, Hospital Clínic, Biomedical Investigation Institute August Pi i Sunyer, Barcelona, Spain.
Bladé
J
J
Service of Hematology, Hospital Clínic, Biomedical Investigation Institute August Pi i Sunyer, Barcelona, Spain.
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001536:Bence Jones Protein / Q000378:metabolism; D003030:Coagulase / Q000032:analysis; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D005455:Fluorescent Antibody Technique; D005922:Glomerulonephritis, IGA / Q000139:chemically induced / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D011695:IgA Vasculitis / Q000209:etiology* / Q000382:microbiology; D007070:Immunoglobulin A / Q000378:metabolism; D008297:Male; D009101:Multiple Myeloma / Q000150:complications* / Q000378:metabolism; D010956:Plasmapheresis; D051437:Renal Insufficiency / Q000209:etiology; D013203:Staphylococcal Infections / Q000150:complications / Q000382:microbiology; D013210:Staphylococcus / Q000201:enzymology; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use
D003030:Coagulase; D007070:Immunoglobulin A; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D001536:Bence Jones Protein