PMID- 34159010
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210624
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 13
IP  - 5
DP  - 2021 May 18
TI  - Light Chain Deposition Disease Diagnosed Using Computed Tomography-Guided Kidney 
      Biopsy.
PG  - e15102
LID - 10.7759/cureus.15102 [doi]
LID - e15102
AB  - Light chain deposition disease (LCDD) is characterized by the deposition of 
      monoclonal immunoglobulin light chains in the kidney, which can cause end-stage 
      kidney disease if not treated. While kidney biopsy is required for definitive 
      diagnosis, choosing an appropriate biopsy method may be problematic when 
      examining patients with atrophic kidneys. A 66-year-old Japanese man was referred 
      to our institution with a three-month history of leg edema. Clinical 
      investigations revealed proteinuria levels of 7.5 g/day. CT-guided percutaneous 
      kidney biopsy was selected as the biopsy method because atrophic kidneys were 
      poorly visualized on ultrasonography. Kidney biopsy revealed nodular 
      glomerulosclerosis, exclusive deposition of the kappa chain, and powdery 
      electron-dense deposits, all of which were indicative of LCDD. Bence-Jones 
      protein was detected in the urine. The patient also had an abnormal serum-free 
      light chain ratio. Bone marrow biopsy revealed multiple myeloma; therefore, the 
      patient was diagnosed to have LCDD with multiple myeloma. The patient was treated 
      with daratumumab, bortezomib, cyclophosphamide, and dexamethasone. After a 
      one-year follow-up, the patient had hematological and renal responses without any 
      treatment-related adverse effects. Our case demonstrates the effectiveness of 
      daratumumab as a treatment for LCDD with nephrotic-range proteinuria. 
      Additionally, we suggest that CT-guided kidney biopsy should be considered as a 
      diagnostic test in patients with kidney atrophy when making a definitive 
      diagnosis.
CI  - Copyright (c) 2021, Shimamura et al.
FAU - Shimamura, Yoshinosuke
AU  - Shimamura Y
AD  - Department of Nephrology, Teine Keijinkai Medical Center, Sapporo, JPN.
FAU - Ogawa, Yayoi
AU  - Ogawa Y
AD  - Department of Renal Pathology, Hokkaido Renal Pathology Center, Sapporo, JPN.
FAU - Takizawa, Hideki
AU  - Takizawa H
AD  - Department of Nephrology, Teine Keijinkai Medical Center, Sapporo, JPN.
FAU - Hayashi, Toshiaki
AU  - Hayashi T
AD  - Department of Hematology, Teine Keijinkai Medical Center, Sapporo, JPN.
FAU - Sakurai, Yasuo
AU  - Sakurai Y
AD  - Department of Radiology, Teine Keijinkai Medical Center, Sapporo, JPN.
LA  - eng
PT  - Case Reports
DEP - 20210518
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC8212893
OTO - NOTNLM
OT  - bortezomib
OT  - computed tomography
OT  - daratumumab
OT  - kidney biopsy
OT  - light chain deposition disease
COIS- The authors have declared that no competing interests exist.
EDAT- 2021/06/24 06:00
MHDA- 2021/06/24 06:01
PMCR- 2021/05/18
CRDT- 2021/06/23 07:21
PHST- 2021/06/23 07:21 [entrez]
PHST- 2021/06/24 06:00 [pubmed]
PHST- 2021/06/24 06:01 [medline]
PHST- 2021/05/18 00:00 [pmc-release]
AID - 10.7759/cureus.15102 [doi]
PST - epublish
SO  - Cureus. 2021 May 18;13(5):e15102. doi: 10.7759/cureus.15102.