A Case of Multiple Myeloma and Renal Failure in a Young Patient
- 1 Nephology Unit, Hamad Medical Corporation, Doha, Qatar
- 2 Nephology Unit, Hamad Medical Corporation, Doha, Qatar
- 3 Medicine Department, Hamad Medical Corporation, Doha, Qatar
- 4 Medicine Department, Hamad Medical Corporation, Doha, Qatar
- 5 Nephology Unit, Hamad Medical Corporation, Doha, Qatar
Abstract
Multiple myeloma is a malignant plasma cell disorder that affects the kidney with various clinical presentations. The most common renal manifestation of multiple myeloma is myeloma cast nephropathy. We are describing a young patient with mul tiple myeloma presented with back pain, anemia and renal impairment. The renal biopsy showed a myeloma cast nephropathy. She was treated with myeloma chemo therapy, high cut-off hemodialysis and autologous hematopoietic stem cell trans plantation with good outcome. We report this rare case of multiple myeloma pre sented with myeloma cast nephropathy (MCN) in a young patient to describe the evidence of light chain removal strategies including plasmapheresis and high cut-off hemodialysis for the management of myeloma cast nephropathy.
- Kyle, R.A. and Rajkumar, S.V. (2004) Multiple Myeloma. The New England Journal of Medicine, 351, 1860-1873. https://doi.org/10.1056/NEJMra041875
- Landgren, O., Kyle, R.A. and Rajkumar, S.V. (2011) From Myeloma Precursor Disease to Multiple Myeloma: New Diagnostic Concepts and Opportunities for Early Intervention. Clinical Cancer Research, 17, 1243-1252. https://doi.org/10.1158/1078-0432.CCR-10-1822
- Rajkumar, S.V., Dimopoulos, M.A., Palumbo, A., et al. (2014) International Myeloma Working Group Updated Criteria for the Diagnosis of Multiple Myeloma. The Lancet Oncology, 15, e538. https://doi.org/10.1016/S1470-2045(14)70442-5
- Montseny, J.J., Kleinknecht, D., Meyrier, A., et al. (1998) Long-Term Outcome According to Renal Histological Lesions in 118 Patients with Monoclonal Gammopathies. Nephrol Dial Transplant, 13, 1438-1445. https://doi.org/10.1093/ndt/13.6.1438
- Nasr, S.H., Valeri, A.M., Sethi, S., et al. (2012) Clinicopathologic Correlations in Multiple Myeloma: A Case Series of 190 Patients with Kidney Biopsies. American Journal of Kidney Diseases, 59, 786-794. https://doi.org/10.1053/j.ajkd.2011.12.028
- Korbet, S.M. and Schwartz, M.M. (2006) Multiple myeloma. Journal of the American Society of Nephrology, 17, 2533-2545. https://doi.org/10.1681/ASN.2006020139
- Hutchison, C.A., Basnayake, K. and Cockwell, P. (2009) Serum Free Light Chain Assessment in Monoclonal Gammopathy and Kidney Disease. Nature Reviews Nephrology, 5, 621-628. https://doi.org/10.1038/nrneph.2009.151
- Dimopoulos, M.A., Terpos, E., Chanan-Khan, A., et al. (2010) Renal Impairment in Patients with Multiple Myeloma: A Consensus Statement on Behalf of the International Myeloma Working Group. Journal of Clinical Oncology, 28, 4976-4984. https://doi.org/10.1200/JCO.2010.30.8791
- Winearls, C.G. (1995) Acute Myeloma Kidney. Kidney International, 48, 1347-1361. https://doi.org/10.1038/ki.1995.421
- Zucchelli, P., Pasquali, S., Cagnoli, L. and Ferrari, G. (1988) Controlled Plasma Exchange Trial in Acute Renal Failure due to Multiple Myeloma. Kidney International, 33, 1175-1180. https://doi.org/10.1038/ki.1988.127
- Johnson, W.J., Kyle, R.A., Pineda, A.A., O’Brien, P.C. and Holley, K.E. (1990) Treatment of Renal Failure Associated with Multiple Myeloma. Plasmapheresis, Hemodialysis, and Chemotherapy. Archives of Internal Medicine, 150, 863-869. https://doi.org/10.1001/archinte.1990.00390160111022