A Case of Light Chain Deposition Disease Involving Kidney and Bone Marrow with Microangiopathic Hemolytic Anemia.
10.3343/kjlm.2009.29.5.384
- Author:
Young Uk CHO
1
;
Hyun Sook CHI
;
Chan Jeoung PARK
;
Seongsoo JANG
;
Yong Mee CHO
;
Jung Sik PARK
Author Information
1. Department of Laboratory Medicine, Eulji University School of Medicine, Eulji General Hospital, Seoul, Kerea.
- Publication Type:Case Report ; English Abstract
- Keywords:
Light chain deposition disease;
Kidney;
Bone marrow;
Microangiopathic hemolytic anemia
- MeSH:
Anemia, Hemolytic/complications/*diagnosis;
Bone Marrow/*pathology;
Female;
Glomerulonephritis/complications/*diagnosis/pathology;
Humans;
Immunoglobulin Light Chains/*analysis;
Kidney Glomerulus/*pathology/ultrastructure;
Middle Aged;
Paraproteinemias/complications/*diagnosis/immunology
- From:The Korean Journal of Laboratory Medicine
2009;29(5):384-389
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We report a case of light chain deposition disease in a 59-yr-old female showing deposition of monoclonal light chain in the kidney and bone marrow accompanied with a schistocytosis, the morphologic finding of microangiopathic hemolytic anemia. The immunofluorescence examination of the kidney revealed strongly stained kappa-light chain deposits on the glomerular mesangium and capillary wall, tubules, and vessel wall. The electron microscopy demonstrated electron-dense deposits on the glomerular basement membrane and mesangium. Anemia was observed with schistocytosis and Howell-Jolly body in the peripheral blood smears. The immunohistochemical examination of the bone marrow showed the presence of kappa-light chain deposits in scattered plasma cells and thickened vessel wall in the absence of a prominent plasma cell proliferation. Although an immunofixation electrophoresis failed to detect a monoclonal gammopathy, the presence of monoclonal protein could be identified by an abnormal kappa/lambda ratio on the serum free light chain analysis.
