A Case of Light Chain Deposition Disease in a Patient with Diabetes and Nodular Glomerulosclerosis.
10.3904/kjm.2015.88.3.318
- Author:
Kyung Ho LEE
1
;
Soo Hoon KANG
;
Hyun Woo LEE
;
Ga Eun PARK
;
Yun Soo HONG
;
Jung Eun LEE
;
Yoon Goo KIM
Author Information
1. Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jungeun34.lee@samsung.com
- Publication Type:Case Report
- Keywords:
Immunoglobulin light chains;
Diabetic nephropathies;
Multiple myeloma
- MeSH:
Basement Membrane;
Biopsy;
Bone Marrow Examination;
Creatinine;
Diabetic Nephropathies*;
Edema;
Electrophoresis;
Fluorescent Antibody Technique;
Humans;
Immunoglobulin Light Chains;
Kidney;
Korea;
Male;
Microscopy, Electron;
Multiple Myeloma
- From:Korean Journal of Medicine
2015;88(3):318-323
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 50 year-old male with a 10-year history of diabetes was admitted to the hospital for edema and foamy urine. At the time of admission, serum creatinine was 1.99 mg/dL and 24 h urine protein levels were 4.0 g/day. Renal biopsy showed nodular glomerulosclerosis. Immunofluorescence demonstrated the presence of kappa light chains along the glomerular and tubular basement membrane. Electron microscopy showed granular electron-dense deposits along the glomerular subendothelium and tubular basement membrane. Serum protein electrophoresis was negative for a monoclonal spike; however, urine protein electrophoresis demonstrated a monoclonal spike. Bone marrow examination was compatible with multiple myeloma and the patient was diagnosed with light-chain deposition disease associated with multiple myeloma. This report stresses the significant challenges that occur when diagnosing light-chain deposition disease in kidneys of patients with long standing diabetes, and discusses previously reported cases of light-chain deposition disease in Korea.
