title: Light Chain Deposition Disease Diagnosed with Laser Micro-dissection, Liquid Chromatography, and Tandem Mass Spectrometry of Nodular Glomerular Lesions.
abstract: A 42-year-old man developed nephrotic syndrome and rapidly progressive renal failure. Kidney biopsy demonstrated nodular glomerulosclerosis, negative Congo red staining, and no deposition of light or heavy chains. Laser micro-dissection and liquid chromatography with tandem mass spectrometry of nodular lesions revealed the presence of a kappa chain constant region and kappa III variable region, which signified light chain deposition disease. Dexamethasone and thalidomide were effective in decreasing the serum levels of free kappa light chain from 147.0 to 38.0 mg/L, eliminating proteinuria, and halting the worsening of the kidney dysfunction, with serum creatinine levels stable around 4.0 mg/dL for 3 years.
authors.affiliation: Division of Nephrology and Rheumatology, Aichi Medical University School of Medicine, Japan.
authors.forename: Tomomichi
authors.initials: T
authors.lastname: Kasagi
authors.forename: Hironobu
authors.initials: H
authors.lastname: Nobata
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.forename: Naoto
authors.initials: N
authors.lastname: Miura
authors.forename: Shogo
authors.initials: S
authors.lastname: Banno
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Takami
authors.forename: Taro
authors.initials: T
authors.lastname: Yamashita
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ando
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Imai
mesh_terms: D000328:Adult; D001706:Biopsy / Q000379:methods; D002853:Chromatography, Liquid / Q000379:methods; D003907:Dexamethasone / Q000627:therapeutic use*; D004210:Dissection / Q000379:methods; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000097:blood*; D007678:Kidney Glomerulus / Q000473:pathology*; D008297:Male; D009404:Nephrotic Syndrome / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D053719:Tandem Mass Spectrometry / Q000379:methods; D013792:Thalidomide / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007145:Immunoglobulin kappa-Chains; D013792:Thalidomide; D003907:Dexamethasone