title: Myeloma cast nephropathy: a rare cause of primary renal allograft dysfunction.
abstract: We describe a rare case of primary renal allograft dysfunction due to myeloma cast nephropathy in a patient with no prior history of multiple myeloma preceding her transplantation. A 72-year-old woman on hemodialysis for 4 years prior to transplantation due to presumed hypertensive nephrosclerosis developed immediate graft dysfunction posttransplantation. The graft biopsy specimens were consistent with myeloma cast nephropathy for which she was treated with plasmapheresis and chemotherapy using bortezomib and dexamethasone. She achieved partial hematologic remission and recovered excellent graft function by 3 months posttransplantation. This is the first report of successful recovery of renal allograft function after development of cast nephropathy.
authors.affiliation: Department of Nephrology, St John Hospital and Medical Center, Detroit, MI 48236, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Goel
authors.forename: D
authors.initials: D
authors.lastname: Granger
authors.forename: K
authors.initials: K
authors.lastname: Bellovich
authors.forename: M
authors.initials: M
authors.lastname: Marin
authors.forename: H
authors.initials: H
authors.lastname: Qu
authors.forename: M
authors.initials: M
authors.lastname: El-Ghoroury
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001897:Boronic Acids / Q000008:administration & dosage; D000069286:Bortezomib; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D006085:Graft Survival; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy; D010956:Plasmapheresis; D011719:Pyrazines / Q000008:administration & dosage; D012074:Remission Induction
chemical_list: D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib; D003907:Dexamethasone