title: Non-Secretory Myeloma, Diagnosed on Renal Biopsy as Cast Nephropathy.
abstract: Multiple myeloma is a disorder of plasma cells which can involve kidneys in the form of cast nephropathy. Neoplastic plasma cells produce either complete immunoglobulins or fragments of immunoglobulins leading to a monoclonal spike in the serum and/or Bence Jones proteinuria. Very few patients present as non-secretory myeloma when no immunoglobulins (M spike) are produced or only light chains are secreted which can only be detected in urine. Acute renal failure due to cast nephropathy can rarely be the first presentation of multiple myeloma. We here in report a case in which primary diagnosis of multiple myeloma was made on renal biopsy due to its characteristic histomorphology. The diagnosis was later on supported by presence of neoplastic plasma cells in the aspirate and biopsy of bone marrow.
authors: Assistant Professor, Department of Pathology, Dayanand Medical College and Hospital , Ludhiana, Punjab, India .
authors: Sumit
authors: S
authors: Grover
authors: Professor, Department of Pathology, Dayanand Medical College and Hospital , Ludhiana, Punjab, India .
authors: Pavneet Kaur
authors: PK
authors: Selhi
authors: Professor and Head, Department of Pathology, Dayanand Medical College and Hospital , Ludhiana, Punjab, India .
authors: Neena
authors: N
authors: Sood
authors: Professor and Head, Department of Nephrology, Dayanand Medical College and Hospital , Ludhiana, Punjab, India .
authors: Jasvinder Singh
authors: JS
authors: Sandhu
authors: Professor, Department of Pathology, Dayanand Medical College and Hospital , Ludhiana, Punjab, India .
authors: Harpreet
authors: H
authors: Kaur
keywords: Fractured casts; Kidney biopsy; Plasma cell dyscrasia; Protein electrophoresis; Renal failure