Department of Nephrology, Austin Health, Heidelberg, Victoria, Australia.
Nephrol Dial Transplant. 2010 Aug;25(8):2786-9. doi: 10.1093/ndt/gfp715. Epub 2009 Dec 29.
Crescentic glomerulonephritis is a rare complication of AA amyloidosis. There are no clinical case reports of this complicating AL amyloidosis. A 67-year-old man developed rapidly progressive glomerulonephritis (RPGN) on a background of primary AL amyloidosis and IgGkappa multiple myeloma. Investigations for causes of glomerulonephritis were negative, and a renal biopsy confirmed crescentic glomerulonephritis and amyloid deposition. He progressed to end stage kidney disease (ESKD) requiring dialysis after 2 months and died 7 months after diagnosis after further treatment of multiple myeloma failed to arrest progression. We believe this to be the first clinical case report of RPGN complicating primary (AL) renal amyloidosis and multiple myeloma.
新月体肾小球肾炎是 AA 淀粉样变性的罕见并发症。尚无 AL 淀粉样变性并发此并发症的临床病例报告。一名 67 岁男性在原发性 AL 淀粉样变性和 IgGκ 多发性骨髓瘤的基础上发生进行性快速肾小球肾炎(RPGN)。对肾小球肾炎病因的检查均为阴性,肾脏活检证实为新月体肾小球肾炎和淀粉样物质沉积。2 个月后,他进展为终末期肾病(ESKD)需要透析,在多发性骨髓瘤的进一步治疗未能阻止疾病进展后,他于诊断后 7 个月死亡。我们认为这是首例 RPGN 并发原发性(AL)肾淀粉样变性和多发性骨髓瘤的临床病例报告。