PMID- 28509073
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20191120
IS  - 2192-4449 (Print)
IS  - 2192-4449 (Electronic)
IS  - 2192-4449 (Linking)
VI  - 1
IP  - 2
DP  - 2012 Nov
TI  - Systemic and rapidly progressive light-chain deposition disease initially 
      presenting as tubulointerstitial nephritis.
PG  - 117-122
LID - 10.1007/s13730-012-0026-1 [doi]
AB  - A 42-year-old woman was admitted to a hospital after first-time detection of 
      proteinuria and hematuria during a routine medical check-up. Because her serum 
      creatinine level had rapidly increased from 0.9 to 3.2 mg/dl since measurement 
      3 months earlier, she was referred to our hospital. Renal biopsy revealed 
      extensive tubular atrophy and interstitial fibrosis with mild leukocyte 
      infiltration. Glomeruli showed minimal changes, and no immunoglobulin or 
      complement deposition was observed by immunofluorescence. Oral prednisolone was 
      commenced under the diagnosis of chronic tubulointerstitial nephritis, and she 
      discharged once. However, its effects were transient; her renal function 
      deteriorated rapidly and hemodialysis was initiated 5 months after her initial 
      check-up. On readmission, urinary Bence-Jones protein kappa-type was detected, and 
      examination of bone marrow led to a diagnosis of Bence-Jones kappa-type multiple 
      myeloma. Light-chain staining using a renal biopsy specimen obtained 2 months 
      earlier showed kappa-light-chain deposition on tubular basement membranes but not 
      glomeruli. Despite undergoing chemotherapy with vincristine, doxirubicin, and 
      dexamethasone, the patient died suddenly from a cardiac arrhythmia. Autopsy 
      showed kappa-light-chain deposition in the heart, thyroid, liver, lungs, spleen, and 
      ovaries. Congo red staining yielded negative results. Typical light-chain 
      deposition disease (LCDD) characterized by nodular glomerulosclerosis was 
      observed in the kidneys. This case demonstrates that tubulointerstitial nephritis 
      can be an early pathological variant of LCDD, which may be followed by 
      accelerated and massive light-chain deposition in glomeruli.
FAU - Takahashi, Satoko
AU  - Takahashi S
AD  - Division of Nephrology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 
      Iwate, 020-0066, Japan.
FAU - Soma, Jun
AU  - Soma J
AD  - Division of Nephrology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 
      Iwate, 020-0066, Japan. sjun@chuo-hp.jp.
FAU - Nakaya, Izaya
AU  - Nakaya I
AD  - Division of Nephrology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 
      Iwate, 020-0066, Japan.
FAU - Yahata, Mayumi
AU  - Yahata M
AD  - Division of Nephrology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, 
      Iwate, 020-0066, Japan.
FAU - Sakuma, Tsutomu
AU  - Sakuma T
AD  - Division of Pathology, Iwate Prefectural Central Hospital, Morioka, Iwate, 
      020-0066, Japan.
FAU - Yaegashi, Hiroshi
AU  - Yaegashi H
AD  - Division of Pathology, Iwate Prefectural Central Hospital, Morioka, Iwate, 
      020-0066, Japan.
FAU - Sato, Akiyoshi
AU  - Sato A
AD  - Division of Hematology, Iwate Prefectural Central Hospital, Morioka, Iwate, 
      020-0066, Japan.
FAU - Wano, Masaharu
AU  - Wano M
AD  - Division of Hematology, Iwate Prefectural Central Hospital, Morioka, Iwate, 
      020-0066, Japan.
FAU - Sato, Hiroshi
AU  - Sato H
AD  - Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate 
      School of Pharmaceutical Sciences and Medicine, Tohoku University, Sendai, 
      Miyagi, 980-8578, Japan.
LA  - eng
PT  - Journal Article
DEP - 20120719
PL  - Japan
TA  - CEN Case Rep
JT  - CEN case reports
JID - 101636244
PMC - PMC5413647
OTO - NOTNLM
OT  - Cardiac arrhythmia
OT  - Cardiac death
OT  - Light-chain deposition disease
OT  - Monoclonal immunoglobulin deposition disease
OT  - Multiple myeloma
OT  - Tubulointerstitial nephritis
EDAT- 2012/11/01 00:00
MHDA- 2012/11/01 00:01
PMCR- 2012/07/19
CRDT- 2017/05/17 06:00
PHST- 2012/01/14 00:00 [received]
PHST- 2012/06/10 00:00 [accepted]
PHST- 2017/05/17 06:00 [entrez]
PHST- 2012/11/01 00:00 [pubmed]
PHST- 2012/11/01 00:01 [medline]
PHST- 2012/07/19 00:00 [pmc-release]
AID - 10.1007/s13730-012-0026-1 [pii]
AID - 26 [pii]
AID - 10.1007/s13730-012-0026-1 [doi]
PST - ppublish
SO  - CEN Case Rep. 2012 Nov;1(2):117-122. doi: 10.1007/s13730-012-0026-1. Epub 2012 
      Jul 19.