title: Five Sequential Evaluations of Renal Histology in a Patient with Light Chain Deposition Disease.
abstract: A 58-year-old man was referred to our institution for an evaluation of nephrotic range proteinuria. Renal biopsy showed a marked expansion of the mesangial matrix and thickening of glomerular basement membrane (GBM) in periodic acid-silver methenamine (PAM). Immunofluorescence (IF) revealed strong staining for the monoclonal kappa light chain. EM demonstrated massive subendothelial and mesangial dense deposits. As a result, light chain deposition disease (LCDD) was diagnosed. Melphalan and prednisolone (MP) therapy was started, which was continued for 10 years with minimal complications. Serial evaluations of renal histology revealed the resolution of nodular lesions and the glomeruli became nearly normal. MP therapy can therefore be an effective therapeutic option for LCDD if it is continued over the long term.
authors.affiliation: Nephrology Center, Toranomon Hospital, Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ueno
authors.forename: Koichi
authors.initials: K
authors.lastname: Kikuchi
authors.forename: Ryo
authors.initials: R
authors.lastname: Hazue
authors.forename: Koki
authors.initials: K
authors.lastname: Mise
authors.forename: Keiichi
authors.initials: K
authors.lastname: Sumida
authors.forename: Noriko
authors.initials: N
authors.lastname: Hayami
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Suwabe
authors.forename: Junichi
authors.initials: J
authors.lastname: Hoshino
authors.forename: Naoki
authors.initials: N
authors.lastname: Sawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Arizono
authors.forename: Shigeko
authors.initials: S
authors.lastname: Hara
authors.forename: Kenmei
authors.initials: K
authors.lastname: Takaichi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fujii
authors.forename: Kenichi
authors.initials: K
authors.lastname: Ohashi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Ubara
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D050533:Glomerular Basement Membrane / Q000473:pathology*; D005920:Glomerular Mesangium / Q000473:pathology*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000378:metabolism*; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D010265:Paraproteinemias / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D011239:Prednisolone / Q000627:therapeutic use; D011507:Proteinuria / Q000378:metabolism / Q000473:pathology*
chemical_list: D018906:Antineoplastic Agents, Alkylating; D005938:Glucocorticoids; D007145:Immunoglobulin kappa-Chains; D011239:Prednisolone; D008558:Melphalan