Portal de Periódicos da CAPES

IgA-kappa Type Multiple Myeloma Affecting Proximal and Distal Renal Tabules.

2001; The Japanese Society of Internal Medicine; Volume: 40; Issue: 9 Linguagem: Inglês

10.2169/internalmedicine.40.931

1349-7235

Kesami Minemura, Kazuo Ichikawa, Nobuo Itoh, Naomi Suzuki, Masahiro Hara, Satoshi Shigematsu, Hiroaki Kobayashi, Kunihide Hiramatsu, Kiyoshi Hashizume,

Amyloidosis: Diagnosis, Treatment, Outcomes

A 45-year-old male was admitted because of chest pain, lumbago, and bilateral ankle pain. Examination disclosed hypophosphatemic osteomalacia, acquired Fanconi syndrome, and abnormalities in distal nephron such as distal renal tubular acidosis and renal diabetes insipidus. Further exploration revealed IgA kappa multiple myeloma excreting urinary Bence Jones protein (kappa-light chain). Renal biopsy revealed thick basement membranes and elec-tron-dense crystals in proximal tubular epithelial cells. Immunofluorescent studies revealed deposition of kappa-light chain in renal tubular epithelial cells that caused the renal tubular damage. Although the osteomalacia was relieved by medical treatment, the urinary Bence Jones protein and the renal tubular defects were not improved by the chemotherapy for the myeloma. The patient died of exacerbation of multiple myeloma at 50 years of age.