Grandjean Anne-Pascale, Dettwiler Sarah, Saudan Patrick
Service de médecine interne générale, HUG, 1211 Genève 14.
Rev Med Suisse. 2010 Mar 3;6(238):460-6.
Paraproteinaemia is frequent in the population above 50 years of age. It is commonly associated in patients with multiple myeloma with diverse renal involvements, such as cast nephropathy, light chain deposition disease, amyloidosis and Fanconi syndrome. A rapid diagnosis is necessary to implement a specific and aggressive treatment in order to prevent development of end-stage renal disease. Plasma exchanges or daily dialysis with high-cut off filter associated with chemotherapy may decrease the plasmatic concentration and production of monoclonal light chains. Bortezomib, thalidomide and lenalidomide are promising therapeutic agents, whose effects in patients with myeloma-associated renal diseases should be more thoroughly studied. Autologous hematopoietic cell transplantation remains the standard of care treatment for eligible patients.
