Lingaraj Umesh, Vankalakunti Mahesha, Radhakrishnan Hemachandar, Sreedhara C G, Rajanna Sunil
Department of Nephrology, Institute of Nephro Urology, Bengaluru, Karnataka, India.
Saudi J Kidney Dis Transpl. 2015 Sep;26(5):970-5. doi: 10.4103/1319-2442.164581.
We report a rare case of primary renal allograft dysfunction due to myeloma cast nephropathy in a patient with no overt clinical features of multiple myeloma preceding his transplantation. A 45-year-old man on hemodialysis for six months for end-stage kidney disease due to presumed chronic glomerulonephritis developed immediate graft dysfunction post-transplantation. The graft biopsy was diagnostic of myeloma cast nephropathy. Other criteria for lambda light chain multiple myeloma were fulfilled with immunofixation electrophoresis and bone marrow biopsy. He was treated with plasmapheresis, bortezomib and high-dose dexamethasone. However, the patient succumbed to septicemia on the 37 th post-operative day. This is probably the first report of primary renal allograft dysfunction due to myeloma cast nephropathy diagnosed within the first week post-transplanation in a patient with unrecognized multiple myeloma.
我们报告了一例罕见的原发性肾移植功能障碍病例，病因是骨髓瘤管型肾病，该患者在移植前没有明显的多发性骨髓瘤临床特征。一名45岁男性因推测的慢性肾小球肾炎导致终末期肾病接受了6个月的血液透析，移植后立即出现移植肾功能障碍。移植肾活检诊断为骨髓瘤管型肾病。免疫固定电泳和骨髓活检满足了λ轻链多发性骨髓瘤的其他标准。他接受了血浆置换、硼替佐米和高剂量地塞米松治疗。然而，患者在术后第37天死于败血症。这可能是首例在移植后第一周内诊断为骨髓瘤管型肾病导致的原发性肾移植功能障碍的病例，该患者此前未被识别出患有多发性骨髓瘤。
