Multiple Myeloma-Associated Light Chain Amyloidosis and a Proposed Approach to Monoclonal Immunoglobulin-Associated Renal Disease
Many challenges remain in diagnosing monoclonal immunoglobulin-associated renal disease, despite widespread application of immunofluorescence (IF) and immunohistochemistry. Here, we report a newly diagnosed case of multiple myeloma with clinical suspicion of renal amyloidosis, which had negative IF...
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doaj-7c7950f94685474c850bcf790a14f9a32020-11-25T01:54:17ZengKarger PublishersCase Reports in Nephrology and Dialysis2296-97052020-09-011039510310.1159/000508785508785Multiple Myeloma-Associated Light Chain Amyloidosis and a Proposed Approach to Monoclonal Immunoglobulin-Associated Renal DiseaseZi Yun ChangThomas Paulraj ThambooClarice Shi Hui ChoongWeng Kin WongClara Lee Ying NgohMany challenges remain in diagnosing monoclonal immunoglobulin-associated renal disease, despite widespread application of immunofluorescence (IF) and immunohistochemistry. Here, we report a newly diagnosed case of multiple myeloma with clinical suspicion of renal amyloidosis, which had negative IF staining for kappa and lambda light chains in the glomeruli. Although laser microdissection and mass spectrometry-based proteomic analysis have emerged as important tools for amyloid typing in the literature, such facilities are still not widely available in Asia. We propose that a clinicopathological algorithm for the evaluation of organized monoclonal renal deposits, together with a combined nephrological-haematological approach, will still be adequate to generate an unequivocal diagnosis in the majority of cases.https://www.karger.com/Article/FullText/508785immunoglobulin deposition diseasemyelomaamyloidosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Zi Yun Chang Thomas Paulraj Thamboo Clarice Shi Hui Choong Weng Kin Wong Clara Lee Ying Ngoh |
spellingShingle |
Zi Yun Chang Thomas Paulraj Thamboo Clarice Shi Hui Choong Weng Kin Wong Clara Lee Ying Ngoh Multiple Myeloma-Associated Light Chain Amyloidosis and a Proposed Approach to Monoclonal Immunoglobulin-Associated Renal Disease Case Reports in Nephrology and Dialysis immunoglobulin deposition disease myeloma amyloidosis |
author_facet |
Zi Yun Chang Thomas Paulraj Thamboo Clarice Shi Hui Choong Weng Kin Wong Clara Lee Ying Ngoh |
author_sort |
Zi Yun Chang |
title |
Multiple Myeloma-Associated Light Chain Amyloidosis and a Proposed Approach to Monoclonal Immunoglobulin-Associated Renal Disease |
title_short |
Multiple Myeloma-Associated Light Chain Amyloidosis and a Proposed Approach to Monoclonal Immunoglobulin-Associated Renal Disease |
title_full |
Multiple Myeloma-Associated Light Chain Amyloidosis and a Proposed Approach to Monoclonal Immunoglobulin-Associated Renal Disease |
title_fullStr |
Multiple Myeloma-Associated Light Chain Amyloidosis and a Proposed Approach to Monoclonal Immunoglobulin-Associated Renal Disease |
title_full_unstemmed |
Multiple Myeloma-Associated Light Chain Amyloidosis and a Proposed Approach to Monoclonal Immunoglobulin-Associated Renal Disease |
title_sort |
multiple myeloma-associated light chain amyloidosis and a proposed approach to monoclonal immunoglobulin-associated renal disease |
publisher |
Karger Publishers |
series |
Case Reports in Nephrology and Dialysis |
issn |
2296-9705 |
publishDate |
2020-09-01 |
description |
Many challenges remain in diagnosing monoclonal immunoglobulin-associated renal disease, despite widespread application of immunofluorescence (IF) and immunohistochemistry. Here, we report a newly diagnosed case of multiple myeloma with clinical suspicion of renal amyloidosis, which had negative IF staining for kappa and lambda light chains in the glomeruli. Although laser microdissection and mass spectrometry-based proteomic analysis have emerged as important tools for amyloid typing in the literature, such facilities are still not widely available in Asia. We propose that a clinicopathological algorithm for the evaluation of organized monoclonal renal deposits, together with a combined nephrological-haematological approach, will still be adequate to generate an unequivocal diagnosis in the majority of cases. |
topic |
immunoglobulin deposition disease myeloma amyloidosis |
url |
https://www.karger.com/Article/FullText/508785 |
work_keys_str_mv |
AT ziyunchang multiplemyelomaassociatedlightchainamyloidosisandaproposedapproachtomonoclonalimmunoglobulinassociatedrenaldisease AT thomaspaulrajthamboo multiplemyelomaassociatedlightchainamyloidosisandaproposedapproachtomonoclonalimmunoglobulinassociatedrenaldisease AT clariceshihuichoong multiplemyelomaassociatedlightchainamyloidosisandaproposedapproachtomonoclonalimmunoglobulinassociatedrenaldisease AT wengkinwong multiplemyelomaassociatedlightchainamyloidosisandaproposedapproachtomonoclonalimmunoglobulinassociatedrenaldisease AT claraleeyingngoh multiplemyelomaassociatedlightchainamyloidosisandaproposedapproachtomonoclonalimmunoglobulinassociatedrenaldisease |
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