title: Spontaneous splenic rupture in a patient with light-chain deposition disease undergoing autologous peripheral blood stem cell transplantation.
abstract: Light-chain deposition disease (LCDD) is a rare plasma cell neoplasm that secretes an abnormal immunoglobulin light chain, which is deposited in tissues, leading to organ dysfunction. Spontaneous splenic rupture is a rare and life-threatening complication of treatment with granulocyte colony-stimulating factor (G-CSF). Herein, we describe spontaneous splenic rupture after the administration of lenograstim to a patient with LCDD undergoing autologous stem cell transplantation (ASCT). The patient was successfully treated by transcatheter embolization of the splenic artery, and long-term stringent complete remission was attained. Plasma cell neoplasms, including multiple myeloma with amyloidosis, are among the most commonly reported conditions associated with spontaneous splenic rupture in patients undergoing ASCT. This finding suggests that, in addition to the effect of G-CSF on the spleen, a combination of factors, including tissue vulnerability induced by the infiltration of abnormal immunoglobulins, may be involved in the pathogenesis of spontaneous splenic rupture. Notably, splenomegaly is not always evident in these patients. Surgical treatment may not be an option, because of severe myelosuppression, and thus less invasive treatment using transcatheter embolization may be feasible.
authors.affiliation: Department of Hematology, Iizuka Hospital.
authors.forename: Shojiro
authors.initials: S
authors.lastname: Haji
authors.forename: Junichi
authors.initials: J
authors.lastname: Kiyasu
authors.forename: Yoshimichi
authors.initials: Y
authors.lastname: Tachikawa
authors.forename: Jiro
authors.initials: J
authors.lastname: Toyonaga
authors.forename: Motohiko
authors.initials: M
authors.lastname: Ikeda
authors.forename: Mariko
authors.initials: M
authors.lastname: Tsuda
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsukamoto
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Kozuru
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yufu
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D010265:Paraproteinemias / Q000150:complications*; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D012422:Rupture, Spontaneous / Q000188:drug therapy / Q000209:etiology*; D013161:Splenic Rupture / Q000188:drug therapy / Q000209:etiology*; D014182:Transplantation, Autologous / Q000009:adverse effects; D016896:Treatment Outcome