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

Authors

  • Vilma Takayasu Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brasil.
  • Silvana Maria Lovisolo Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brasil.
  • Leonardo de Abreu Testagrossa Faculdade de Medicina – Universidade de São Paulo, São Paulo/SP, Brasil.
  • Aloísio Felipe-Silva Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brasil.

DOI:

https://doi.org/10.4322/acr.2016.006

Keywords:

Multiple myeloma, Autopsy, Thrombosis, Acute kidney injury, Myeloma proteins.

Abstract

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.

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Author Biographies

  • Vilma Takayasu, Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brasil.
    Divisão de Clínica Médica do Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brasil.
  • Silvana Maria Lovisolo, Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brasil.
    Serviço de Anatomia Patológica do Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brasil.
  • Leonardo de Abreu Testagrossa, Faculdade de Medicina – Universidade de São Paulo, São Paulo/SP, Brasil.
    Divisão de Anatomia Patológica do Hospital das Clínicas da Faculdade de Medicina – Universidade de São Paulo, São Paulo/SP, Brasil.
  • Aloísio Felipe-Silva, Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brasil.
    Serviço de Anatomia Patológica do Hospital Universitário – Universidade de São Paulo, São Paulo/SP, Brasil.

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Published

2011-06-08

Issue

Vol. 1 No. 2 (2011)

Section

Article / Autopsy Case Report

License

Authors of articles published by Autopsy and Case Report retain the copyright of their work without restrictions, licensing it under the Creative Commons Attribution License - CC-BY, which allows articles to be re-used and re-distributed without restriction, as long as the original work is correctly cited.

How to Cite

Takayasu, V., Lovisolo, S. M., Testagrossa, L. de A., & Felipe-Silva, A. (2011). Renal vein thrombosis, light-chain deposition disease and cast nephropathy in a multiple myeloma patient. Autopsy and Case Reports, 1(2). https://doi.org/10.4322/acr.2016.006