Case Report on Cast Nephropathy Resolution in Multiple Myeloma
Author Information
Author(s): Basnayake Kolitha, Hutchison Colin, Kamel Dia, Sheaff Michael, Ashman Neil, Cook Mark, Oakervee Heather, Bradwell Arthur, Cockwell Paul
Primary Institution: Queen Elizabeth Medical Centre, University Hospital Birmingham
Hypothesis
Can rapid reduction of serum free light chains lead to resolution of cast nephropathy in patients with multiple myeloma?
Conclusion
Cast nephropathy can quickly resolve with a rapid reduction of monoclonal serum free light chains.
Supporting Evidence
- Serum free light chain concentrations fell to less than 5% of the starting level after treatment.
- A repeat renal biopsy showed resolution of cast nephropathy after 6 weeks.
- The patient remained symptomatically well and the myeloma was in remission one year after treatment.
Takeaway
A woman with kidney problems due to multiple myeloma got better after doctors removed harmful proteins from her blood quickly.
Methodology
The patient was treated with chemotherapy and high cut-off haemodialysis to reduce serum free light chain concentrations.
Limitations
The patient did not recover renal function despite the resolution of casts, possibly due to pre-existing interstitial fibrosis.
Participant Demographics
61-year-old Caucasian woman
Digital Object Identifier (DOI)
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