PMID- 17613994
OWN - NLM
STAT- MEDLINE
DCOM- 20070823
LR  - 20090626
IS  - 1521-0758 (Electronic)
IS  - 0191-3123 (Linking)
VI  - 31
IP  - 2
DP  - 2007 Mar-Apr
TI  - Morphologic manifestations of combined light-chain deposition disease and 
      light-chain cast nephropathy.
PG  - 141-9
AB  - There are few data on morphology of light-chain deposition disease (LCDD) of 
      kidney with coexistent light-chain cast nephropathy (LCCN). Here, the authors 
      report the morphology in 23 cases of LCDD and LCCN. They retrospectively 
      evaluated 23 renal biopsies with light (LM), immunofluorescence (IF), and 
      electron microscopy (EM). Twenty-one patients had myeloma, 1 had a monoclonal 
      gammopathy, and in 1 no illness was found. Nodular glomerulosclerosis, the LM 
      lesion suggestive of LCDD, was noted in only 3 of 23 cases. Glomeruli were 
      unremarkable in 16 (69%) cases. The diagnostic casts of LCCN were seen in all 
      biopsies. Linear light chain (LC) immunoreactivity was observed in 23 (100%) 
      cases (18 kappa, 5 lambda); GBM + TBM in 13, TBM only in 7, GBM only in 1, TBM 
      and interstitium in 1, GBM, TBM and mesangium in 1. Casts were positive with same 
      LC in all cases (100%). Fifteen cases (65%) showed granular electron-dense 
      deposits; GBM only in 5, TBM only in 5, GBM and TBM in 4, mesangium in 1. In 8 
      patients without EM deposits, the diagnosis of LCDD was rendered by IF. Fifteen 
      (65%) had deposits detectable by IF and EM, 8 (37%) had deposits with IF only. 
      LCCN dominated the LM findings in all patients. There were minimal or no 
      glomerular changes by LM. This study shows the lack of characteristic LM findings 
      of LCDD in combined cases of LCDD and LCCN and emphasizes the difficulty 
      for-definitive diagnosis-without IF and EM.
FAU - Gokden, Neriman
AU  - Gokden N
AD  - Department of Pathology, University of Arkansas for Medical Sciences, Little 
      Rock, Arkansas 72205, USA. gokdenneriman@uams.edu
FAU - Cetin, Neslihan
AU  - Cetin N
FAU - Colakoglu, Nagihan
AU  - Colakoglu N
FAU - Kumar, Jayant
AU  - Kumar J
FAU - Abul-Ezz, Sameh
AU  - Abul-Ezz S
FAU - Barlogie, Bart
AU  - Barlogie B
FAU - Liapis, Helen
AU  - Liapis H
FAU - Walker, Patrick D
AU  - Walker PD
LA  - eng
PT  - Journal Article
PL  - England
TA  - Ultrastruct Pathol
JT  - Ultrastructural pathology
JID - 8002867
RN  - 0 (Immunoglobulin Light Chains)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Glomerular Basement Membrane/immunology/metabolism/ultrastructure
MH  - Humans
MH  - Immune Complex Diseases/immunology/metabolism/*pathology
MH  - *Immunoglobulin Light Chains
MH  - Kidney Diseases/immunology/metabolism/*pathology
MH  - Kidney Tubules/immunology/metabolism/*ultrastructure
MH  - Male
MH  - Microscopy, Electron, Transmission
MH  - Microscopy, Fluorescence
MH  - Middle Aged
MH  - Retrospective Studies
EDAT- 2007/07/07 09:00
MHDA- 2007/08/24 09:00
CRDT- 2007/07/07 09:00
PHST- 2007/07/07 09:00 [pubmed]
PHST- 2007/08/24 09:00 [medline]
PHST- 2007/07/07 09:00 [entrez]
AID - 779835056 [pii]
AID - 10.1080/01913120701376139 [doi]
PST - ppublish
SO  - Ultrastruct Pathol. 2007 Mar-Apr;31(2):141-9. doi: 10.1080/01913120701376139.