Renal vein thrombosis, light-chain deposition disease and cast nephropathy in a multiple myeloma patient

A 56-year-old woman presented with thoracic pain and dyspnea for 3 days. She had been under treatment for systemic arterial hypertension for 16 years. Laboratory investigation showed acute renal failure with indication for hemodialysis. After dialysis, despite improvements in clinical and laboratory...

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Main Authors: Vilma Takayasu, Silvana Maria Lovisolo, Leonardo de Abreu Testagrossa, Aloísio Felipe-Silva
Format: Article
Language:English
Published: University of São Paulo 2011-06-01
Series:Autopsy and Case Reports
Subjects:
Online Access:http://www.revistas.usp.br/autopsy/article/view/36418
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spelling doaj-deb3f2769976467e8b7e18b2e8807a2b2020-11-24T21:13:40ZengUniversity of São PauloAutopsy and Case Reports2236-19602011-06-011210.4322/acr.2016.00636326Renal vein thrombosis, light-chain deposition disease and cast nephropathy in a multiple myeloma patientVilma TakayasuSilvana Maria LovisoloLeonardo de Abreu TestagrossaAloísio Felipe-SilvaA 56-year-old woman presented with thoracic pain and dyspnea for 3 days. She had been under treatment for systemic arterial hypertension for 16 years. Laboratory investigation showed acute renal failure with indication for hemodialysis. After dialysis, despite improvements in clinical and laboratory parameters, she had an episode of ventricular fibrillation and cardiac arrest which was promptly reverted. She was still oliguric but without neurological deficits. A laboratory work up for multiple myeloma was started. Serum protein  electrophoresis showed hypogammaglobulinemia without a monoclonal peak. While on laboratory work up, the patient had another episode of ventricular fibrillation and died. The autopsy showed left renal vein thrombosis, bone marrow involvement by a plasmacytic myeloma, light-chain deposition disease with diffuse glomerular and tubular involvement and also myeloma cast nephropathy. This case illustrates a rarely documented association between myeloma cast nephropathy, renal light-chain deposition disease and renal vein thrombosis in a multiple myeloma patient with acute renal failure.http://www.revistas.usp.br/autopsy/article/view/36418Multiple myelomaAutopsyThrombosisAcute kidney injuryMyeloma proteins.
collection DOAJ
language English
format Article
sources DOAJ
author Vilma Takayasu
Silvana Maria Lovisolo
Leonardo de Abreu Testagrossa
Aloísio Felipe-Silva
spellingShingle Vilma Takayasu
Silvana Maria Lovisolo
Leonardo de Abreu Testagrossa
Aloísio Felipe-Silva
Renal vein thrombosis, light-chain deposition disease and cast nephropathy in a multiple myeloma patient
Autopsy and Case Reports
Multiple myeloma
Autopsy
Thrombosis
Acute kidney injury
Myeloma proteins.
author_facet Vilma Takayasu
Silvana Maria Lovisolo
Leonardo de Abreu Testagrossa
Aloísio Felipe-Silva
author_sort Vilma Takayasu
title Renal vein thrombosis, light-chain deposition disease and cast nephropathy in a multiple myeloma patient
title_short Renal vein thrombosis, light-chain deposition disease and cast nephropathy in a multiple myeloma patient
title_full Renal vein thrombosis, light-chain deposition disease and cast nephropathy in a multiple myeloma patient
title_fullStr Renal vein thrombosis, light-chain deposition disease and cast nephropathy in a multiple myeloma patient
title_full_unstemmed Renal vein thrombosis, light-chain deposition disease and cast nephropathy in a multiple myeloma patient
title_sort renal vein thrombosis, light-chain deposition disease and cast nephropathy in a multiple myeloma patient
publisher University of São Paulo
series Autopsy and Case Reports
issn 2236-1960
publishDate 2011-06-01
description A 56-year-old woman presented with thoracic pain and dyspnea for 3 days. She had been under treatment for systemic arterial hypertension for 16 years. Laboratory investigation showed acute renal failure with indication for hemodialysis. After dialysis, despite improvements in clinical and laboratory parameters, she had an episode of ventricular fibrillation and cardiac arrest which was promptly reverted. She was still oliguric but without neurological deficits. A laboratory work up for multiple myeloma was started. Serum protein  electrophoresis showed hypogammaglobulinemia without a monoclonal peak. While on laboratory work up, the patient had another episode of ventricular fibrillation and died. The autopsy showed left renal vein thrombosis, bone marrow involvement by a plasmacytic myeloma, light-chain deposition disease with diffuse glomerular and tubular involvement and also myeloma cast nephropathy. This case illustrates a rarely documented association between myeloma cast nephropathy, renal light-chain deposition disease and renal vein thrombosis in a multiple myeloma patient with acute renal failure.
topic Multiple myeloma
Autopsy
Thrombosis
Acute kidney injury
Myeloma proteins.
url http://www.revistas.usp.br/autopsy/article/view/36418
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