Thanikachalam Sowmya, Srinivasalu Vijay Kumar, Nataraj K S, Damodar Sharat, Das Manjula
Tumor Immunology Program, Mazumdar Shaw Medical Foundation, Bangalore, India.
Department of Medical Oncology, Mazumdar Shaw Medical Centre, Bangalore, India.
Case Rep Oncol. 2021 Mar 2;14(1):274-278. doi: 10.1159/000510046. eCollection 2021 Jan-Apr.
We present a case report of a 62-year-old male, treated for kappa light chain multiple myeloma with chemotherapy followed by autologous stem cell transplant (ASCT) in 2014. He has been in complete remission for 4 years. In 2018, he was evaluated for hypercreatinemia and acute kidney injury(AKI) with a suspicion of disease relapse; he underwent evaluation with bone marrow aspiration cytology which showed no evidence of relapse. However, careful cytogenetic analyses showed IgH amplification (14q32) which probably was the cause for AKI in the absence of any structural abnormality in the kidney. Heavy chain deposition leads to AKI in multiple myeloma, and its association with IgH amplification leading to AKI is reported here. Though heavy chain deposition leading to AKI is common, IgH amplification at chromosome level is the first case observed.
我们报告一例62岁男性病例，该患者于2014年接受化疗及自体干细胞移植（ASCT）治疗kappa轻链多发性骨髓瘤。他已完全缓解4年。2018年，他因血肌酐升高和急性肾损伤（AKI）接受评估，怀疑疾病复发；他接受了骨髓穿刺细胞学检查，未发现复发迹象。然而，仔细的细胞遗传学分析显示免疫球蛋白重链（IgH）扩增（14q32），这可能是在肾脏无任何结构异常情况下导致AKI的原因。重链沉积可导致多发性骨髓瘤患者发生AKI，本文报道了其与导致AKI的IgH扩增之间的关联。虽然重链沉积导致AKI很常见，但染色体水平的IgH扩增是首次观察到的病例。
