Resolution of mesangial light chain deposits 3 years after high-dose melphalan with autologous peripheral blood stem cell transplantation.
A 52-year-old woman was admitted to our hospital for treatment of nephrotic syndrome. Funduscopic findings showed fundal hemorrhage and soft exudates, and serologic analysis showed a monoclonal serum component that was identified as Bence Jones protein-k type. A bone marrow biopsy showed diffuse proliferation of atypical plasma cells, while a renal biopsy showed diffuse and nodular mesangial proliferation. Immunohistochemical staining confirmed the presence of k chains along the glomerular basement membrane and in mesangial areas. The patient was diagnosed as multiple myeloma (Bence Jones k type) with light chain deposition disease (LCDD). After high-dose melphalan and autologous peripheral blood stem cell transplantation (PBSCT), the multiple myeloma and nephrotic syndrome were in complete remission; her renal function was improved, but a renal biopsy performed 6 months after PBSCT showed the persistence of diffuse and nodular lesions. By contrast, a renal biopsy performed 3 years later showed complete resolution of the diffuse and nodular mesangial proliferation.
Harada
K
K
First Department of Internal Medicine, Nara Medical University, Nara, Japan.
Akai
Y
Y
Sakan
H
H
Yamaguchi
Y
Y
Nakatani
K
K
Iwano
M
M
Saito
Y
Y
D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage*; D001536:Bence Jones Protein / Q000378:metabolism; D001706:Biopsy; D005260:Female; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000378:metabolism*; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000276:immunology / Q000601:surgery / Q000628:therapy*; D008558:Melphalan / Q000008:administration & dosage*; D050527:Mesangial Cells / Q000187:drug effects* / Q000276:immunology; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000276:immunology / Q000601:surgery; D009404:Nephrotic Syndrome / Q000276:immunology / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation; D012074:Remission Induction; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D018906:Antineoplastic Agents, Alkylating; D007147:Immunoglobulin Light Chains; D001536:Bence Jones Protein; D008558:Melphalan