Crystalline podocytopathy and tubulopathy without overt glomerular proteinuria in a patient with multiple myeloma

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• 作者：Eun Jeong Lee¹ ; Su Yeon Lee¹ ; So Young Park¹ ; Yonjin Kim¹ ; Jae Shin Choi¹ ; Mi Jeoung Kim² ; Ji Hyeon Park³ ; ⁴ ; Jung Eun Lee³ ; Ghee Young Kwon⁵ ; Yoon-Goo Kim³ ; ^{yoongoo.kim@samsung.com}
• 关键词：Fanconi syndrome ; Multiple myeloma ; Nephropathy
• 刊名：Kidney Research and Clinical Practice
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：35
• 期：4
• 页码：259-262
• 全文大小：1324 K
• 卷排序：35

文摘

Crystalline nephropathy is a rare yet well-known condition associated with multiple myeloma and other light chain–secreting disorders. Paraproteins that are resistant to proteolysis crystallize within proximal tubular cells and cause light-chain proximal tubulopathy, which presents clinically as Fanconi syndrome. Podocytes are rarely affected, and the crystalline inclusions within podocytes are typically precipitated, yielding significant glomerular proteinuria. Here we report a case of extensive crystalline inclusions primarily within podocytes and proximal tubules that presented only with Fanconi syndrome and renal insufficiency. Despite the presence of extensive crystalline inclusions in podocytes and diffuse foot process effacement, the patient had no clinical evidence suggestive of podocyte injury.