PMID- 18300034
OWN - NLM
STAT- MEDLINE
DCOM- 20080313
LR  - 20090626
IS  - 1521-0758 (Electronic)
IS  - 0191-3123 (Linking)
VI  - 32
IP  - 1
DP  - 2008 Jan-Feb
TI  - Morphologic heterogeneity of renal light-chain deposition disease.
PG  - 17-24
LID - 10.1080/01913120701854002 [doi]
AB  - Light-chain deposition disease (LCDD) of the kidney is defined as deposition of 
      monotypic light chains (LC) within glomerular (GBM) and tubular (TBM) basement 
      membranes. The morphologic features of pure renal LCDD have been presented only 
      in case reports or small series. The aim of this study was to perform a 
      comprehensive evaluation of the light (LM), immunofluorescence (IF), and electron 
      microscopic (EM) features of pure renal LCDD in a large series of biopsies. Out 
      of 46 cases assembled, 42 had multiple myeloma, 2 had monoclonal gammopathy of 
      unknown significance, and in 2 patients no lymphoproliferative disease was 
      identified. The most common LM lesion of LCDD, nodular glomerulosclerosis, was 
      present in only 14 (30%) cases. GBM and/or TBM thickening was found in 3 (6%), 
      mild to moderate mesangial matrix increase in 12 (23%), and unremarkable 
      glomeruli and tubules were seen in 15 (32%) cases. Forty-two had IF and 40 (92%) 
      showed characteristic linear LC immunoreactivity (24 kappa, 16 lambda) along GBM 
      and/or TBM. Among 39 cases in which IF and EM was available, 25 (64%) were 
      positive by both. Two (6%) were negative by IF, but had deposits by EM. In 12 
      (30%) with immunoreactivity to LC (4 kappa, 8 lambda), no deposits were 
      identified ultrastructurally. This study shows heterogeneous LM lesions in pure 
      LCDD cases. LM alone may be suspicious but not diagnostic of LCDD. 
      Immunofluorescence is more sensitive than EM for detection of LC for the 
      definitive diagnosis of LCDD. This study supports the importance of utilizing 
      kappa and lambda stains in the routine IF panel for diagnosis of LCDD.
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 - Barlogie, Bart
AU  - Barlogie B
FAU - Liapis, Helen
AU  - Liapis H
LA  - eng
PT  - Journal Article
PL  - England
TA  - Ultrastruct Pathol
JT  - Ultrastructural pathology
JID - 8002867
RN  - 0 (Immunoglobulin Light Chains)
SB  - IM
MH  - Basement Membrane/ultrastructure
MH  - Female
MH  - Fluorescent Antibody Technique, Direct
MH  - Glomerular Mesangium/ultrastructure
MH  - Humans
MH  - Immune Complex Diseases/immunology/*pathology
MH  - *Immunoglobulin Light Chains
MH  - Kidney Diseases/immunology/*pathology
MH  - Kidney Glomerulus/immunology/*ultrastructure
MH  - Male
MH  - Microscopy, Electron, Transmission
MH  - Middle Aged
MH  - Multiple Myeloma/immunology/*pathology
MH  - Prospective Studies
MH  - Retrospective Studies
EDAT- 2008/02/27 09:00
MHDA- 2008/03/14 09:00
CRDT- 2008/02/27 09:00
PHST- 2008/02/27 09:00 [pubmed]
PHST- 2008/03/14 09:00 [medline]
PHST- 2008/02/27 09:00 [entrez]
AID - 790903483 [pii]
AID - 10.1080/01913120701854002 [doi]
PST - ppublish
SO  - Ultrastruct Pathol. 2008 Jan-Feb;32(1):17-24. doi: 10.1080/01913120701854002.