[A case of light chain deposition disease involving kidney and bone marrow with microangiopathic hemolytic anemia].

Abstract

We report a case of light chain deposition disease in a 59-yr-old female showing deposition of monoclonal light chain in the kidney and bone marrow accompanied with a schistocytosis, the morphologic finding of microangiopathic hemolytic anemia. The immunofluorescence examination of the kidney revealed strongly stained kappa-light chain deposits on the glomerular mesangium and capillary wall, tubules, and vessel wall. The electron microscopy demonstrated electron-dense deposits on the glomerular basement membrane and mesangium. Anemia was observed with schistocytosis and Howell-Jolly body in the peripheral blood smears. The immunohistochemical examination of the bone marrow showed the presence of kappa-light chain deposits in scattered plasma cells and thickened vessel wall in the absence of a prominent plasma cell proliferation. Although an immunofixation electrophoresis failed to detect a monoclonal gammopathy, the presence of monoclonal protein could be identified by an abnormal kappa/lambda ratio on the serum free light chain analysis.

• Authors: Young Uk Cho, Hyun Sook Chi, Chan Jeoung Park, Seongsoo Jang, Yong Mee Cho, Jung Sik Park
• Journal: The Korean journal of laboratory medicine (Korean J Lab Med) Vol. 29 Issue 5 Pg. 384-9 (Oct 2009) ISSN: 1598-6535 [Print] Korea (South)
• PMID: 19893345 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Immunoglobulin Light Chains

Topics

• Anemia, Hemolytic (complications, diagnosis)
• Bone Marrow (pathology)
• Female
• Glomerulonephritis (complications, diagnosis, pathology)
• Humans
• Immunoglobulin Light Chains (analysis)
• Kidney Glomerulus (pathology, ultrastructure)
• Middle Aged
• Paraproteinemias (complications, diagnosis, immunology)