title: Acute renal failure with lambda light chain-derived crystals in a patient with IgD myeloma.
abstract: Kidney involvement with immunoglobulin crystals usually relates to a light chain of the kappa type, in MGUS or smoldering myeloma, frequently causing Fanconi's syndrome with progressive renal insufficiency. We report on a case with severe myeloma featuring lambda light chain-derived crystals and acute kidney injury. Histology showed acute tubular necrosis and tubule obstruction with crystals, which were also abundant inside tubule epithelial cells, macrophages and bone marrow plasma cells. The light chain variable domain had a normal overall primary structure but included 11 somatic mutations, 3 of which likely increased the surface hydrophobicity, as observed in previously reported kappa-type crystals.
authors: Institut national de la santé et de la recherche médicale, UMR S 938, système immunitaire et maladies conformationnelles, Hôpital St Antoine, Paris, France.
authors: Cécile
authors: C
authors: Toly-Ndour
authors: Julie
authors: J
authors: Peltier
authors: Rémi
authors: R
authors: Piedagnel
authors: Paul
authors: P
authors: Coppo
authors: Emmanuelle
authors: E
authors: Sachon
authors: Pierre
authors: P
authors: Ronco
authors: Eric
authors: E
authors: Rondeau
authors: Patrice
authors: P
authors: Callard
authors: Pierre
authors: P
authors: Aucouturier
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000473:pathology*; D000595:Amino Acid Sequence; D006801:Humans; D007072:Immunoglobulin D / Q000276:immunology*; D007147:Immunoglobulin Light Chains / Q000235:genetics / Q000276:immunology*; D007146:Immunoglobulin lambda-Chains / Q000235:genetics / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009101:Multiple Myeloma / Q000150:complications* / Q000473:pathology*; D017386:Sequence Homology, Amino Acid
chemical_list: D007072:Immunoglobulin D; D007147:Immunoglobulin Light Chains; D007146:Immunoglobulin lambda-Chains