Marked improvement by high-dose chemotherapy and autologous stem cell transplantation in a case of light chain deposition disease.
A 55-year-old woman presented with heavy proteinuria (6.2 g/day) in April 2007. Because monoclonal IgG-k was detected in serum and urine samples, bone marrow aspiration and renal biopsy were performed. She was diagnosed with plasma cell dyscrasia because a bone marrow aspiration specimen showed plasma cells at 6.1%. Renal tissues revealed the formation of nodular glomerulosclerosis which was negative for Congo-red staining. Renal immunohistochemistry showed positive staining for kappa light chains in the nodular lesions, proximal tubules and part of Bowman's capsules. Her renal involvement was diagnosed as light chain deposition disease. Proteinuria disappeared and renal function stabilized after high-dose chemotherapy and autologous stem cell transplantation. It appears that an early initiation of active therapy such as high-dose chemotherapy and autologous stem cell transplantation may be beneficial for patients with light chain deposition disease.
Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
Keiichi
K
Matsuzaki
Isao
I
Ohsawa
Tomohito
T
Nishitani
Yukihiko
Y
Takeda
Hiroyuki
H
Inoshita
Masaya
M
Ishii
Miyuki
M
Takagi
Satoshi
S
Horikoshi
Yasuhiko
Y
Tomino
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001706:Biopsy; D050476:Bowman Capsule / Q000378:metabolism / Q000473:pathology; D003131:Combined Modality Therapy; D003907:Dexamethasone / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000378:metabolism*; D007687:Kidney Tubules, Proximal / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D010265:Paraproteinemias / Q000150:complications / Q000276:immunology / Q000628:therapy*; D033581:Stem Cell Transplantation; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D000970:Antineoplastic Agents; D007145:Immunoglobulin kappa-Chains; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin