Abstract | RATIONALE: PATIENT CONCERNS: A 54-year-old male presented with progressively aggravated bone pain and limitation of activity was admitted to our department. A proximal renal tubular damage was suggested by hypophosphatemia, compensated metabolic acidosis, renal glycosuria, aminoaciduria, and hypouricemia. M- protein of IgA kappa was detected by immunofixation electrophoresis. Mildly increased plasma cells were found in bone marrow cytomorphologic examination. Renal biopsy revealed diffuse linear monoclonal IgA-kappa light chain deposits along tubular basement membranes (TBMs), while lambda was negative. Electron microscopy showed granular electron-dense deposits along the outer aspect of TBMs. DIAGNOSES: INTERVENTIONS: OUTCOMES: We reported a rare case of adult acquired FS with hypophosphatemic osteomalacia secondary to LCDD associated with MGRS and the patient was successfully treated with bortezomib. LESSONS: Although few cases of LCDD with isolated symptoms of tubulointerstitial nephropathy, rather than glomerular symptoms have been reported. It still needs to be recognized as a differential diagnosis in monoclonal gammopathy.
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Authors | Haiyan Tu, Lijun Mou, Lina Zhu, Qifeng Jiang, Dave Schwinn Gao, Ying Hu |
Journal | Medicine
(Medicine (Baltimore))
Vol. 97
Issue 36
Pg. e12027
(Sep 2018)
ISSN: 1536-5964 [Electronic] United States |
PMID | 30200082
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Immunoglobulin kappa-Chains
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Topics |
- Diagnosis, Differential
- Fanconi Syndrome
(diagnosis, drug therapy, etiology, pathology)
- Humans
- Immunoglobulin kappa-Chains
(analysis)
- Kidney Diseases
(complications, diagnosis, drug therapy, pathology)
- Male
- Middle Aged
- Paraproteinemias
(complications, diagnosis, drug therapy, pathology)
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