Kappa light chain myeloma: A case report

Abstract

Light chain myeloma nephropathy is the most common form of renal involvement in plasma cell dyscrasias. It usually causes tubulointerstitial renal damage. About one in five people with multiple myeloma produce only light chains. We report a case of lambda light chain deposition disease in a 61-year-old female who presented with acute renal failure . She is currently in partial remission following treatment with bortezomib, cyclophosphamide, and steroids.We present a case with rare kappa light chain myeloma with light chain deposition in renal tubules.

Keywords

• kappa myeloma
• light chain
• acute renal failure

References

1. Mollee P, Tate J. Monitoring of light chain myeloma - time for a change. Br J Haematol. 2017 Jul;178(2):177-8. doi: 10.1111/bjh.14752.
2. Chen J, Fang M, Zhao YP, Yi CH, Ji J, Cheng C, Wang MM, Gu X, Sun QS, Chen XL, Gao CF. Serum N-glycans: A new diagnostic biomarker for light chain multiple myeloma. PLoS One. 2015 Jun 15;10(6):e0127022. doi: 10.1371/journal.pone.0127022.
3. Zhang JJ, Sun WJ, Huang ZX, Chen SL, Zhong YP, Hu Y, An N, Shen M, Li X. Light chain multiple myeloma, clinic features, responses to therapy and survival in a long-term study. World J Surg Oncol. 2014 Jul 28;12:234. doi: 10.1186/1477-7819-12-234.
4. Knudsen LM, Hippe E, Hjorth M, Holmberg E, Westin J. Renal function in newly diagnosed multiple myeloma--a demographic study of 1353 patients. The Nordic Myeloma Study Group. Eur J Haematol. 1994 Oct;53(4):207-12. doi: 10.1111/j.1600-0609.1994.tb00190.x.
5. Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A, Fonseca R, Rajkumar SV, Offord JR, Larson DR, Plevak ME, Therneau TM, Greipp PR. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc. 2003 Jan;78(1):21-33. doi: 10.4065/78.1.21.
6. Ecotière L, Thierry A, Debiais-Delpech C, Chevret S, Javaugue V, Desport E, Belmouaz S, Quellard N, Kaaki S, Goujon JM, Fermand JP, Touchard G, Bridoux F. Prognostic value of kidney biopsy in myeloma cast nephropathy: a retrospective study of 70 patients. Nephrol Dial Transplant. 2016 Jan;31(1):64-72. doi: 10.1093/ndt/gfv283.
7. Hutchison CA, Heyne N, Airia P, Schindler R, Zickler D, Cook M, Cockwell P, Grima D. Immunoglobulin free light chain levels and recovery from myeloma kidney on treatment with chemotherapy and high cut-off haemodialysis. Nephrol Dial Transplant. 2012 Oct;27(10):3823-8. doi: 10.1093/ndt/gfr773.
8. Hasegawa M, Kondo F, Yamamoto K, Murakami K, Tomita M, Nabeshima K, Nakai S, Kato M, Ohashi A, Arai J, Hiki Y, Ishii J, Emi N, Sugiyama S, Yuzawa Y. Evaluation of blood purification and bortezomib plus dexamethasone therapy for the treatment of acute renal failure due to myeloma cast nephropathy. Ther Apher Dial. 2010 Oct;14(5):451-6. doi: 10.1111/j.1744-9987.2010.00863.x.