title: Crystalline light chain proximal tubulopathy with chronic renal failure and silicone gel breast implants: 1 case report.
abstract: A 39-year-old female patient was admitted to explore chronic renal failure. Clinical history included silicone breast implants. Clinical examination was normal. Urinalysis revealed tubular proteinuria with Bence-Jones κ protein. Monoclonal immunoglobulin G κ and free monoclonal κ-light chains (LCs) were revealed by serum protein immunoelectrophoresis. Bone marrow aspiration with karyotype analysis and skeletal radiologic survey were normal. Kidney biopsy revealed a peculiar pattern of proximal tubular cells with hypertrophy and clarification initially diagnosed as an osmotic nephrosis. Immunofluorescence study, including immunoglobulin LCs conjugates was normal. Immunoelectron microscopy finally revealed a crystalline LC proximal tubulopathy κ. Our case presents some peculiarities: the absence of hematologic malignancy sign and the young patient's age. The silicone breast implants have been reported to be involved in the generation of monoclonal gammopathy.
authors.affiliation: Laboratoire d'Anatomie Pathologique, Hôpital Necker, Assistance Publique, Hôpitaux de Paris, Université Paris Descartes, 75015, Paris, France. Electronic address: mlucile.figueres@gmail.com.
authors.forename: Marie-Lucile
authors.initials: ML
authors.lastname: Figueres
authors.affiliation: Service de Néphrologie, Hôpital du Val de Grâce, 75005 Paris, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Beaume
authors.affiliation: Laboratoire d'Anatomie Pathologique Pol Bouin, Hôpital Robert Debré, 51092 Reims, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Vuiblet
authors.affiliation: Laboratoire d'Anatomie Pathologique, Hôpital Necker, Assistance Publique, Hôpitaux de Paris, Université Paris Descartes, 75015, Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Rabant
authors.affiliation: Service de Néphrologie, Clinique Turin, 75008 Paris, France.
authors.forename: Nader
authors.initials: N
authors.lastname: Bassilios
authors.affiliation: Service de Néphrologie, Hôpital du Val de Grâce, 75005 Paris, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Herody
authors.affiliation: Service de Néphrologie, CHU de Poitiers, Université de Poitiers, 86000 Poitiers, France.
authors.forename: Guy
authors.initials: G
authors.lastname: Touchard
authors.affiliation: Laboratoire d'Anatomie Pathologique, Inserm U1016, Hôpital Necker, Assistance Publique, Hôpitaux de Paris, Université Paris Descartes, 75015 Paris, France.
authors.forename: Laure-Hélène
authors.initials: LH
authors.lastname: Noël
mesh_terms: D000328:Adult; D001536:Bence Jones Protein / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001706:Biopsy; D019928:Breast Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D018427:Breast Implants / Q000009:adverse effects*; D003460:Crystallization; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D006984:Hypertrophy; D007145:Immunoglobulin kappa-Chains / Q000097:blood* / Q000652:urine; D007676:Kidney Failure, Chronic / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D007687:Kidney Tubules, Proximal / Q000276:immunology* / Q000648:ultrastructure; D016253:Microscopy, Immunoelectron; D010265:Paraproteinemias / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012307:Risk Factors; D020034:Silicone Gels / Q000009:adverse effects*
chemical_list: D015415:Biomarkers; D007145:Immunoglobulin kappa-Chains; D020034:Silicone Gels; D001536:Bence Jones Protein
keywords: Crystalline nephropathy; Light chain proximal tubulopathy; Monoclonal gammopathy; Osmotic nephrosis; Silicone implants