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Kidney failure as an unusual initial presentation of biclonal gammopathy (IgD multiple myeloma associated with light chain disease)--a case report


, : Kidney failure as an unusual initial presentation of biclonal gammopathy (IgD multiple myeloma associated with light chain disease)--a case report. Vojnosanitetski Pregled 72(2): 196-199

Immunoglobulin D (IgD) myeloma is a rare disease, about 2% of all myelomas, even rarer when accompanied with another multiple myeloma in biclonal gammopathy. We presented a case of biclonal gammopathy-as-sociated manifestation of IgD myeloma and light chain disease in a patient who initially had renal failure. 37-year-old male approximately one month before hospitalization began to feel malaise and fatigue along with decreased urination. Laboratory analysis revealed azotemia. A dialysis catheter was placed and hemodialysis started. The patient was then admitted to our hospital for further tests and during admission, objective examination revealed pronounced paleness with hepatosplenomegaly and hypertension (170/95 mmHg). Laboratory analysis showed erythrocyte sedimentation rate 122 mm/h, expressed anemic syndrome (Hb 71 g/L) and renal failure dialysis rank: creatinine 1,408 micromol/L, urea 31.7 mmol/L. There was two M components in serum protein electrophoresis: IgD lambda and free light chain lambda. Proteinuria was nephrotic rank (5.4 g/24 h), whose electrophoresis revealed 2 M components--massive in alpha 2 fraction of 71%; 7% in the discrete beta fraction, beta 2M / serum 110 mg / L, in urine 1.8 mg/L--extremely high; IgL kappa I lambda index 1:13 (reference value ratio 2:1). The findings pointed to double myeloma disease: IgD myeloma and Bence Jones lambda myeloma. Bone biopsy confirmed IgD myeloma lambda 100% infiltration medulla predominantly plasmablasts. The treatment continued with hemodialysis 3 times per week with chemotherapy protocol bortezomib, doxorubicin, dexamethasone. After 4 cycles of chemotherapy, there was a decrease of IgD, lamda-light chains, reduction in proteinuria (1.03 g/24 h), so hemodialysis was reduced to once per week. Six months after treatment initiation the patient underwent autologous bone marrow transplantation. In a 2-year follow-up period double myeloma disease showed complete remission. The presented rare form of double myeloma disease with initial renal insufficiency underscores the importance of careful observation and teamwork that can alter the course of this serious disease.

US$29.90

PMID: 25831916


Other references

Kuisi, M.Al.; Abdel-Fattah, A., 2010: Groundwater vulnerability to selenium in semi-arid environments: Amman Zarqa Basin, Jordan. An evaluation of approximately 250 samples of groundwater in the Amman Zarqa Basin for selenium along with other major and trace elements showed that concentrations of Se ranged between 0.09 and 742 microg/L, with an average value of about 24 micr...

Dreyer, E.M.; Weisenseel, M.H., 1979: Phytochrome-mediated uptake of calcium in Mougeotia cells. Ca(2+) is proposed to function as a messenger in such phytochrome-mediated responses as localized cell growth, intracellular movements, and control of plasma membrane properties. To test this hypothesis, the uptake of Ca(2+) in irradiated and non-...

Clark, B.B.; Greene, J.A., 1935: Effect of low carbohydrate diet on glucose tolerance in spontaneous hypoglycemia. When 2 patients with spontaneous hypoglycemia ingested diets low in carbohydrate and high in fat for periods of 5 and 24 mos. respectively their symptoms improved and the glucose tolerance diminished. Glucose tolerance was measured by double toler...

Wagner D., 1985: Biology and description of the larva of dicymolomia metalliferalis a case bearing glaphyriine pyralidae. The larval biology of Dicymolomia metalliferalis (Packard) is described. Larvae were collected from partially opened, necrotic seed pods of two Lupinus L. species and reared to adults. Larvae fed from within purse-like cases constructed of silk an...

Liu, G.Y.; Baker, D.; Fairchild, S.; Figueroa, F.; Quartey Papafio, R.; Tone, M.; Healy, D.; Cooke, A.; Turk, J.L.; Wraith, D.C., 1993: Complete characterization of the expressed immune response genes in Biozzi AB/H mice: structural and functional identity between AB/H and NOD A region molecules. Biozzi AB/H mice (selected for high antibody response to heterologous erythrocytes) were serologically characterised using a panel of monoclonal antibodies detecting class I and class II MHC determinants. The reactivity pattern is tabulated. A new...

Pulford, D.J.; Britton, P., 1991: Expression and cellular localisation of porcine transmissible gastroenteritis virus N and M proteins by recombinant vaccinia viruses. Porcine transmissible gastroenteritis virus (TGEV) nucleoprotein and integral membrane protein genes were cloned into the vaccinia virus insertion vector, pGS20, in the correct orientation for expression under the control of the vaccinia P7.5K pro...

Sakamoto K.; Okada S.; Lam G.K.Y.; Henkelman R.M.; Skarsgard L.D., 1979: The comparative survival of clonogenic cells of a murine epithelioma irradiated in vivo with 250 kvp x rays cobalt 60 gamma rays or negative pions produced by the cyclotron at triumf. Squamous carcinomas [spontaneously arisen, but not transplanted] in WHT/Ht mice were exposed to the biomedical pion beam at TRIUMF. The biological effects of the pion beam were compared to those of 250 kVp X-rays. The dose rates were 2-3 rad/min (...

Boneschi, M.; Erba, M.; Giuffrida, G.F.; Mattioli, A.; Miani, S., 1993: Functioning paraganglioma. Pheochromocytomas and functioning paragangliomas are rare tumors arising from indifferent cells of the primitive neural crest. These tumors produce clinical symptoms (pheochromocytoma syndrome) related to catecholamine production. The pheochromocy...

Ishikawa, K.; Sasaki, S.; Matsufuji, H., 2004: High b-carotene and Capsaicinoid Contents in Seedless Fruits of 'Shishitoh Pepper. HortScience 39(1): 3-5

Sieghart, W., 2013: Anxioselective anxiolytics: additional perspective. Trends in Pharmacological Sciences 34(3): 145-146