caa a22 4500 445883200 CHVBK 20180317145551.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s10157-011-0437-x doi (NATIONALLICENCE)springer-10.1007/s10157-011-0437-x Renal failure caused by plasma cell infiltration in multiple myeloma [Elektronische Daten] [Shiho Hanawa, Tetsu Akimoto, Eisuke Uehara, Makoto Inoue, Toshimi Imai, Atsushi Kotoda, Hiromichi Yoshizawa, Tomohiro Matsuyama, Masuzu Ueda, Osamu Saito, Yoshitomo Hamano, Wako Yumura, Keiya Ozawa, Shigeaki Muto, Eiji Kusano] We report on a case of severe renal failure in a 61-year-old female with multiple myeloma (MM). Two months prior to admission, the patient was diagnosed to have anemia and progressive renal failure associated with urinary Bence Jones protein and was referred to our hospital. A bone marrow biopsy revealed 40% plasma cells with κ light chain restriction. Thus, she was considered to have MM. A renal biopsy revealed neoplastic plasma cell infiltration within the kidney, moderate interstitial fibrosis, tubular atrophy, and punctate, electron-dense material along the peripheral capillary walls, tubular basement membrane, and in the interstitium of the kidney. This suggested that a combination of compression of the tubules and the microvasculature by the infiltrative process, and local light chain deposition-mediated tissue damage might be implicated in the development of renal failure in this patient. Despite a remission of bone marrow plasmacytosis with a bortezomib-based regimen, her renal function gradually deteriorated and a periodic hemodialysis program was finally required. Although the clinical impact of the direct kidney infiltration of neoplastic plasma cells on the longitudinal changes in renal function remains to be delineated, it is reasonable to consider that the infiltration of neoplastic plasma cells associated with local light chain depositions may result in irreversible renal injuries. Obviously, further studies and accumulation of additional experience with renal biopsy are required to better determine the precise and prognostic relationship between renal outcome and morphological alterations among MM patients with varying degrees of renal impairment. Japanese Society of Nephrology, 2011 Multiple myeloma nationallicence Plasma cell infiltration nationallicence Renal failure nationallicence Renal biopsy nationallicence Bortezomib nationallicence Hanawa Shiho Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Akimoto Tetsu Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Uehara Eisuke Division of Hematology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut Inoue Makoto Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Imai Toshimi Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Kotoda Atsushi Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Yoshizawa Hiromichi Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Matsuyama Tomohiro Division of Hematology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut Ueda Masuzu Division of Hematology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut Saito Osamu Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Hamano Yoshitomo Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Yumura Wako Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Ozawa Keiya Division of Hematology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut Muto Shigeaki Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Kusano Eiji Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Clinical and Experimental Nephrology Springer Japan 15/4(2011-08-01), 586-590 1342-1751 15:4<586 2011 15 10157 https://doi.org/10.1007/s10157-011-0437-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-011-0437-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hanawa Shiho Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Akimoto Tetsu Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Uehara Eisuke Division of Hematology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Inoue Makoto Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Imai Toshimi Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Kotoda Atsushi Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Yoshizawa Hiromichi Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Matsuyama Tomohiro Division of Hematology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Ueda Masuzu Division of Hematology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Saito Osamu Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Hamano Yoshitomo Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Yumura Wako Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Ozawa Keiya Division of Hematology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Muto Shigeaki Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Kusano Eiji Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/4(2011-08-01), 586-590 1342-1751 15:4<586 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer