A Case of Light Chain Deposition Disease in a Patient with Diabetes and Nodular Glomerulosclerosis |
Kyung Ho Lee, Soo Hoon Kang, Hyun Woo Lee, Ga Eun Park, Yun Soo Hong, Jung Eun Lee, Yoon Goo Kim |
Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea |
당뇨 환자에서 결절성 사구체 경화증으로 경쇄 침착 질환이 진단된 1예 |
이경호, 강수훈, 이현우, 박가은, 홍연수, 이정은, 김윤구 |
성균관대학교 의과대학 삼성서울병원 내과 |
Correspondence:
Jung Eun Lee, Tel: +82-2-3410-3449, Fax: +82-2-3410-0064, Email: jungeun34.lee@samsung.com |
Received: 25 February 2014 • Revised: 19 March 2014 • Accepted: 2 May 2014 |
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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Abstract |
A 50 year-old male with a 10-year history of diabetes was admitted to the hospital for edema and foamy urine. At the time of admission, serum creatinine was 1.99 mg/dL and 24 h urine protein levels were 4.0 g/day. Renal biopsy showed nodular glomerulosclerosis. Immunofluorescence demonstrated the presence of kappa light chains along the glomerular and tubular basement membrane. Electron microscopy showed granular electron-dense deposits along the glomerular subendothelium and tubular basement membrane. Serum protein electrophoresis was negative for a monoclonal spike; however, urine protein electrophoresis demonstrated a monoclonal spike. Bone marrow examination was compatible with multiple myeloma and the patient was diagnosed with light-chain deposition disease associated with multiple myeloma. This report stresses the significant challenges that occur when diagnosing light-chain deposition disease in kidneys of patients with long standing diabetes, and discusses previously reported cases of light-chain deposition disease in Korea. |
Key Words:
Immunoglobulin light chains; Diabetic nephropathies; Multiple myeloma |
주제어:
경쇄 침착 질환; 당뇨 신 질환; 다발성 골수종 |
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