title: Treatment of Light Chain Deposition Disease Using Bortezomib-Based Regimen Followed by Thalidomide-Based Regimen in a Saudi Male.
abstract: Light chain deposition disease (LCDD) is a rare illness with, as yet, no clear evidence-based guidelines for its treatment. To the best of our knowledge, LCDD has not been previously reported from Saudi Arabia. We present in this report, a 38-year-old Saudi male who presented with clinical features suggestive of hypertensive nephropathy but kidney biopsy later revealed the diagnosis of LCDD. His serum creatinine at presentation was 297μmol/L which came down to 194μmol/L on treatment with Bortezomib, Cyclophosphamide and Dexamethasone. His 24-hour protein excretion at presentation was 6 g/L which also came down to less than 1 g/day. He was later placed on Cyclophosphamide, Thalidomide, and Dexamethasone regimen because of persistent high titres of serum free light chains. He went into remission with undetectable serum free light chains and remained so for three years at the time of writing this report. We conclude that LCDD, though rare, does occur in Saudi population. The treatment of LCDD is challenging but the use of Bortezomib, a proteosome inhibitor, is promising. However, suboptimal response may require further treatment with other therapeutic options such as chemotherapy with alkylating agents or high-dose Melphalan with autologous stem cell transplant.
authors.affiliation: College of Medicine, University of Bisha, Bisha, Saudi Arabia.
authors.forename: Bappa
authors.identifier: 0000-0002-6935-3715
authors.initials: B
authors.lastname: Adamu
authors.affiliation: College of Medicine, University of Bisha, Bisha, Saudi Arabia.
authors.forename: Mushabab
authors.initials: M
authors.lastname: Al-Ghamdi
authors.affiliation: Department of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ahmad
authors.affiliation: Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
authors.forename: Khaled O
authors.identifier: 0000-0003-3389-9035
authors.initials: KO
authors.lastname: Alsaad