Dysseleer A, Michaux L, Cosyns J P, Goffin E, Hermans C, Pirson Y
Department of Nephrology, Haematology, and Pathology, Université Catholique de Louvain Medical School, Brussels, Belgium.
Am J Kidney Dis. 1999 Jul;34(1):166-9. doi: 10.1016/s0272-6386(99)70125-3.
The fate of preexisting benign monoclonal gammopathy after organ transplantation is largely unknown. We report the case of a 47-year-old male kidney graft recipient with a pretransplantation IgG kappa monoclonal gammopathy who developed, 10 years after transplantation, de novo augloid light chain (AL) amyloidosis involving skin and kidney graft. The potential role of heavy immunosuppressive treatment in the development of this complication is discussed. The possible occurrence of AL amyloidosis should be kept in mind when a patient with benign monoclonal gammopathy is evaluated for organ transplantation, as well as when a transplanted patient with pre-existing monoclonal gammopathy develops new onset of proteinuria.
器官移植后先前存在的良性单克隆丙种球蛋白病的转归在很大程度上尚不清楚。我们报告了一例47岁男性肾移植受者的病例，该患者移植前存在IgG κ单克隆丙种球蛋白病，在移植10年后发生了累及皮肤和肾移植的新发淀粉样轻链（AL）淀粉样变性。讨论了强化免疫抑制治疗在该并发症发生中的潜在作用。当对患有良性单克隆丙种球蛋白病的患者进行器官移植评估时，以及当患有先前存在的单克隆丙种球蛋白病的移植患者出现蛋白尿新发病例时，应考虑到AL淀粉样变性可能发生。
