論文

査読有り 国際誌
2015年1月

A case of endocapillary proliferative glomerulonephritis with macrophages phagocytosing monoclonal immunoglobulin lambda light chain.

Pathology international
  • Hirofumi Watanabe
  • Yutaka Osawa
  • Shin Goto
  • Masato Habuka
  • Naofumi Imai
  • Yumi Ito
  • Takayuki Hirose
  • Takaaki Chou
  • Ryuji Ohashi
  • Akira Shimizu
  • Takashi Ehara
  • Takashi Shimotori
  • Ichiei Narita
  • 全て表示

65
1
開始ページ
38
終了ページ
42
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1111/pin.12229
出版者・発行元
WILEY-BLACKWELL

Multiple myeloma (MM) is a plasma-cell neoplasm that can cause renal disorders. Renal lesions in MM can present with a very rare pathological manifestation involving a specific monoclonal immunoglobulin (Ig). We report the case of a 33-year-old woman who had edema, fatigue, elevated serum creatinine levels, hypoalbuminemia, and hypercholesterolemia. She had persistent hematuria and proteinuria lasting 3 years. Serum protein electrophoresis showed an M-spike, and serum immunofixation demonstrated the presence of monoclonal IgG λ. She had proteinuria in the nephrotic range, and a monoclonal λ fragment was present on urine immunofixation. Renal biopsy showed proliferative glomerulonephritis with λ light chain and C3c deposition and inflammatory cell infiltration with CD68. Macrophage lysosomes contained λ light chains, suggesting their partial phagocytosis. She was diagnosed with symptomatic MM and was treated with bortezomib and dexamethasone and an autologous peripheral stem cell transplant conditioned with intravenous melphalan. She achieved a partial response with decreased serum monoclonal protein and improved renal function. This case may be categorized as a monoclonal gammopathy-associated proliferative glomerulonephritis. The biopsy finding of partially phagocytosed Ig λ light chains by macrophages is very rare; this pathological condition is similar to crystal-storing histiocytosis.

リンク情報
DOI
https://doi.org/10.1111/pin.12229
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/25410550
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000347317200007&DestApp=WOS_CPL
ID情報
  • DOI : 10.1111/pin.12229
  • ISSN : 1320-5463
  • eISSN : 1440-1827
  • PubMed ID : 25410550
  • Web of Science ID : WOS:000347317200007

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