PMID- 25441103
OWN - NLM
STAT- MEDLINE
DCOM- 20151201
LR  - 20150214
IS  - 1432-2277 (Electronic)
IS  - 0934-0874 (Linking)
VI  - 28
IP  - 3
DP  - 2015 Mar
TI  - Monoclonal gammopathy of renal significance with light-chain deposition disease 
      diagnosed postrenal transplant: a diagnostic and therapeutic challenge.
PG  - 375-9
LID - 10.1111/tri.12497 [doi]
AB  - Patients with light-chain deposition disease (LCDD) frequently do not meet 
      criteria for myeloma. In such cases, despite low tumor burden, the circulating 
      monoclonal immunoglobulins cause renal damage, are responsible for 
      post-transplant recurrence, and are rightly categorized as monoclonal gammopathy 
      of renal significance (MGRS) requiring chemotherapy. A 65-year male with 
      uncharacterized nodular glomerulopathy presented with proteinuria 3 years 
      postrenal transplant. His allograft biopsies were diagnostic of light-chain 
      deposition disease (likely recurrent), and in the absence of myeloma, he was 
      labeled as MGRS. Based on the limited literature available, he was treated with 
      bortezomib which resulted in normalization of serum-free light-chain ratios and 
      resolution of proteinuria. He, however, later succumbed to complications of 
      chemotherapy. This case highlights the diagnostic difficulties in LCDD, the 
      importance of an accurate pretransplant diagnosis, and treatment of the malignant 
      clone, in the absence of which post-transplant management of recurrence is 
      challenging with poor outcomes.
CI  - (c) 2014 Steunstichting ESOT.
FAU - Nambirajan, Aruna
AU  - Nambirajan A
AD  - Department of Pathology, All India Institute of Medical Sciences, New Delhi, 
      India.
FAU - Bhowmik, Dipankar
AU  - Bhowmik D
FAU - Singh, Geetika
AU  - Singh G
FAU - Agarwal, Sanjay Kumar
AU  - Agarwal SK
FAU - Dinda, Amit Kumar
AU  - Dinda AK
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20141216
PL  - Switzerland
TA  - Transpl Int
JT  - Transplant international : official journal of the European Society for Organ 
      Transplantation
JID - 8908516
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Immunoglobulin Light Chains)
RN  - 69G8BD63PP (Bortezomib)
SB  - IM
MH  - Aged
MH  - Antineoplastic Agents/therapeutic use
MH  - Biopsy
MH  - Bortezomib/*therapeutic use
MH  - Humans
MH  - Immunoglobulin Light Chains/*metabolism
MH  - Kidney/pathology
MH  - Kidney Failure, Chronic/surgery
MH  - Kidney Transplantation/*adverse effects
MH  - Male
MH  - Monoclonal Gammopathy of Undetermined Significance/*diagnosis/etiology/therapy
OTO - NOTNLM
OT  - MGRS
OT  - bortezomib
OT  - light-chain deposition disease
OT  - myeloma
OT  - transplant
EDAT- 2014/12/03 06:00
MHDA- 2015/12/15 06:00
CRDT- 2014/12/03 06:00
PHST- 2014/07/23 00:00 [received]
PHST- 2014/08/27 00:00 [revised]
PHST- 2014/11/27 00:00 [accepted]
PHST- 2014/12/03 06:00 [entrez]
PHST- 2014/12/03 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
AID - 10.1111/tri.12497 [doi]
PST - ppublish
SO  - Transpl Int. 2015 Mar;28(3):375-9. doi: 10.1111/tri.12497. Epub 2014 Dec 16.