Light-chain deposition disease (LCDD) is a rare
plasma cell neoplasm that secretes an abnormal
immunoglobulin light chain, which is deposited in tissues, leading to organ dysfunction. Spontaneous
splenic rupture is a rare and life-threatening complication of treatment with
granulocyte colony-stimulating factor (
G-CSF). Herein, we describe spontaneous
splenic rupture after the administration of
lenograstim to a patient with LCDD undergoing autologous
stem cell transplantation (ASCT). The patient was successfully treated by transcatheter embolization of the splenic artery, and long-term stringent complete remission was attained.
Plasma cell neoplasms, including
multiple myeloma with
amyloidosis, are among the most commonly reported conditions associated with spontaneous
splenic rupture in patients undergoing ASCT. This finding suggests that, in addition to the effect of
G-CSF on the spleen, a combination of factors, including tissue vulnerability induced by the infiltration of abnormal
immunoglobulins, may be involved in the pathogenesis of spontaneous
splenic rupture. Notably,
splenomegaly is not always evident in these patients. Surgical treatment may not be an option, because of severe myelosuppression, and thus less invasive treatment using transcatheter embolization may be feasible.