[A case of light chain deposition disease involving kidney and bone marrow with microangiopathic hemolytic anemia].
We report a case of light chain deposition disease in a 59-yr-old female showing deposition of monoclonal light chain in the kidney and bone marrow accompanied with a schistocytosis, the morphologic finding of microangiopathic hemolytic anemia. The immunofluorescence examination of the kidney revealed strongly stained kappa-light chain deposits on the glomerular mesangium and capillary wall, tubules, and vessel wall. The electron microscopy demonstrated electron-dense deposits on the glomerular basement membrane and mesangium. Anemia was observed with schistocytosis and Howell-Jolly body in the peripheral blood smears. The immunohistochemical examination of the bone marrow showed the presence of kappa-light chain deposits in scattered plasma cells and thickened vessel wall in the absence of a prominent plasma cell proliferation. Although an immunofixation electrophoresis failed to detect a monoclonal gammopathy, the presence of monoclonal protein could be identified by an abnormal kappa/lambda ratio on the serum free light chain analysis.
Cho
Young Uk
YU
Department of Laboratory Medicine, Eulji University School of Medicine, Eulji General Hospital, Seoul, Kerea.
Chi
Hyun Sook
HS
Park
Chan Jeoung
CJ
Jang
Seongsoo
S
Cho
Yong Mee
YM
Park
Jung Sik
JS
D000743:Anemia, Hemolytic / Q000150:complications / Q000175:diagnosis*; D001853:Bone Marrow / Q000473:pathology*; D005260:Female; D005921:Glomerulonephritis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000032:analysis*; D007678:Kidney Glomerulus / Q000473:pathology* / Q000648:ultrastructure; D008875:Middle Aged; D010265:Paraproteinemias / Q000150:complications / Q000175:diagnosis* / Q000276:immunology
D007147:Immunoglobulin Light Chains