- 期刊
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Lambda Light-Chain Deposition Disease with Myeloma Cast Nephropathy-Induced Renal Failure: A Case Report
λ輕鏈型沈積骨髓瘤併骨髓瘤腎病變引起腎衰竭：一病歷報告
摘要
對於多發性骨髓瘤的病人而言，柱狀蛋白腎病變不僅是最常見的病徵，也是造成腎衰竭的主因，此外多發性骨髓瘤相關的腎衰竭較常出現於輕鏈癒患者，因此在本文中，我們將介紹一位五十四歲的男性病患，其臨床上以嚴重的蛋白尿和腎功能不全作為表現，這位病患除了陣發的輕微腳水腫與蛋白尿，並沒有其他的症狀，如：骨骼疼痛或體重減輕，其尿液鏡檢僅可見到微量蛋白尿而無血尿，但一天蛋白尿流失為3.6克。基於“溢流性蛋白尿”的懷疑，做了腎臟病理切片，此外的檢查還包括：骨髓病理切片，血液蛋白質電泳，尿液蛋白質電泳，以上所有的檢驗均符合λ輕鏈沉積疾病及骨髓瘤柱狀蛋白腎病變。
並列摘要
Not only is cast nephropathy the most frequent lesion in myeloma patients, it is also the major cause of acute renal failure in these patients. Another salient feature of myeloma-related renal failure is the prevalence of pure light-chain myelomas. Here, we describe a 54-year-old man presented with heavy proteinuria associated with impaired renal function. Physical examination only showed mild leg swelling and denied other symptoms such as bone pain or body weight loss. Urine for routine examination revealed only trace proteinuria by bromphenol blue method, and no hematuria and pyuria. However, 24-hour daily proteinuria is about 3.6 g. Renal biopsy was done under the suspicion of 'overflow proteinuria'. Bone marrow biopsy and protein electrophoresis for urine and blood were also performed. All investigations were compatible with lambda light-chain deposition disease and myeloma cast nephropathy.