Journal
AMERICAN JOURNAL OF KIDNEY DISEASES
Volume 35, Issue 3, Pages art. no.-e9Publisher
W B SAUNDERS CO
DOI: 10.1016/S0272-6386(00)70221-6
Keywords
light chain nephropathy; multiple myeloma; nephrotic syndrome; nodular glomerulosclerosis; chemotherapy
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A 64-year-old man developed multiple myeloma (kappa light chain type), nephrotic syndrome, and renal insufficiency in 1993, A renal biopsy showed typical histological findings of light chain nephropathy: nodular glomerulosclerosis with deposition of kappa light chains in the mesangial area and subendothelial space of the glomerular capillary walls. Long-term intermittent MEVP chemotherapy (melphalan, 4 mg/d for 4 days; cyclophosphamide, 100 mg/d for 4 days; vincristine, 1 mg/d; prednisolone, 40 mg/d for 4 days) diminished proteinuria and improved renal function. In April 1999, a follow-up biopsy showed remarkable diminution of nodular lesions and disappearance of kappa light chain deposits. Although the prognosis of light chain nephropathy has been considered poor, long-term successful chemotherapy can clear light chain deposits and restore renal function. (C) 2000 by the National Kidney Foundation, Inc.
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