title: [Kidney involvement in Idiopathic Light Chain disease. Report of one case].
abstract: Idiopathic Light Chain disease (ILCD) is a systemic disease characterized by a deposit in different organs of light chain monoclonal immunoglobulins, produced by an abnormal clone of B cells. It is usually found in the course ofa plasma cell dyscrasia and in other lymphoproliferative alterations; however it may occur in absence of any hematologic disease and is denominated as idiopathic. We report a 51-year-old mole admitted to the hospital due to anasarca. Laboratory evaluation showed a serum creatinine of 1.4 mg/dl, a serum albumin of1.6 g/dl, a serum cholesterol of 687 mg/dl and a proteinuria of 5.3 g/day Light chains with a predominance of a monoclonal component were identified in urinary proteins by electrophoresis and kappa chains were identified by immunofixation. A renal biopsy showed a diffuse nodular glomerulopathy with a 35% tubular atrophy and interstitial sclerosis. Electrón microscopy confirmed light chain deposition. The bone marrow biopsy showed a myeloid hyperplasia. The patient was initially treated with methylprednisolone and plasmapheresis with a reduction in serum creatinine and disappearance of urinary kappa component. Albuminuria persisted and a malnutrition-inflammatory complex syndrome was diagnosed. Hemodialysis with ultrafiltration was started along with cyclophosphamide. The patient received hemodialysis for six months and continued with methylprednisolone.
authors.affiliation: Servicios de Nefrología, Hospital Británico de Buenos Aires, Argentina.
authors.forename: Hernán
authors.initials: H
authors.lastname: Trimarchi
authors.forename: Fernando
authors.initials: F
authors.lastname: Lombi
authors.forename: Mariano
authors.initials: M
authors.lastname: Forrester
authors.forename: Vanesa
authors.initials: V
authors.lastname: Pomeranz
authors.forename: Oscar
authors.initials: O
authors.lastname: Rabinovich
authors.forename: Germán R
authors.initials: GR
authors.lastname: Stemmelin
authors.forename: Pablo A
authors.initials: PA
authors.lastname: Ruiz
authors.forename: Alejandro
authors.initials: A
authors.lastname: Iotti
authors.forename: Pablo
authors.initials: P
authors.lastname: Young
mesh_terms: D003928:Diabetic Nephropathies / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D010265:Paraproteinemias / Q000150:complications* / Q000473:pathology
chemical_list: D007147:Immunoglobulin Light Chains