Multiple myeloma with a previous diagnosis of focal segmental glomerulosclerosis: A case report and review of the literature

Dong, Zheyi; Xing, Hai-Tao; Wang, Yuanda; Zhang, Wei; Qiu, Qiang; Chen, Xiangmei

doi:10.3892/ol.2015.3669

Cited by 3 publications

(5 citation statements)

References 17 publications

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“…Although considered secondary, clinical symptoms of FSGS with underlying PCD may vary: Our patient showed proteinuria in the sub-nephrotic range without edema or hypalbuminemia. In contrast, other cases have been reported in which a full nephrotic syndrome was evident with pronounced proteinuria, edema, and hypalbuminemia [28][29][30][31]. In summary, the clinical picture of FSGS associated with PCD shows a wide range from only moderate proteinuria to full nephrotic syndrome, which should always be taken into account in diagnosis.…”

Section: Discussionmentioning

confidence: 85%

Crystalline deposits in the cornea and various areas of the kidney as symptoms of an underlying monoclonal gammopathy: a case report

et al. 2021

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Background Plasma cell dyscrasias (PCD) are characterized by an abnormal production of intact monoclonal immunoglobulins or parts such as heavy or light chains. In most cases, the monoclonal protein (also termed paraprotein) is produced by a clonal plasma cell population. The production of monoclonal proteins can result in deposits of various types and localization depending on the type, amount, and electrochemical properties of the paraprotein. One histopathologic presentation, albeit rare, are crystalline deposits. They can form in various organs and hence cause a wide spectrum of symptoms. Case presentation A 49-year-old man presented to the emergency department with eyestrain and foreign body sensation after overhead drilling. Examination of the eyes revealed crystalline deposits in the cornea of both eyes. After additional diagnostic testing, deposits were attributed to free light chains. Monoclonal gammopathy of undetermined significance (MGUS) was diagnosed according to serum electrophoresis and immunofixation. Four years later, new onset of proteinuria was detected. A percutaneous biopsy of the kidney showed severe light chain podocytopathy with secondary focal segmental glomerulosclerosis (FSGS) and light chain proximal tubulopathy (LCPT). In these lesions, crystalline deposits identical to the corneal deposits were found in ultrastructural and immunofluorescent analysis. The patient was diagnosed with monoclonal gammopathy of renal significance (MGRS), and a plasma cell directed therapy was initiated. Conclusions PCD can present with a wide array of symptoms and are notoriously difficult to diagnose. Extrarenal manifestations such as crystalline deposits in the cornea are one possible manifestation. The case presented herein emphasizes the notion that extrarenal paraprotein deposits warrant a thorough search for the underlying clonal disease.

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Section: Discussionmentioning

confidence: 85%

Crystalline deposits in the cornea and various areas of the kidney as symptoms of an underlying monoclonal gammopathy: a case report

et al. 2021

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“…FSGS has been reported previously in several cases of lymphoproliferative disorders, including T-cell lymphoma [ 13 ], Hodgkin’s lymphoma [ 14 ], and large granular lymphocytosis [ 15 ]. Cases of FSGS with MM are even more rare and the pathogenesis of this association is unclear [ 4 , 5 , 16 – 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, only 9 cases of FSGS with MM have been reported in the English language literature [ 4 , 5 , 16 , 17 , 19 , 20 ]. The average time between diagnosis of MM and FSGS was about 6–18 months [ 9 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Multiple Myeloma in a Patient with Focal Segmental Glomerulosclerosis: A Case Report

et al. 2018

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Patient: Male, 48Final Diagnosis: Multiple myelomaSymptoms: Back painMedication: —Clinical Procedure: —Specialty: HematologyObjective:Rare diseaseBackground:Focal segmental glomerulosclerosis (FSGS) is a common cause of nephrotic syndrome in adults, which can be primary, or secondary to various causes. Unlike membranous nephropathy, FSGS is less likely to be associated with malignancy. Few cases have been reported of the occurrence of FSGS with hematological malignancies like multiple myeloma (MM).Case Report:A 48-year-old man presented with nephrotic syndrome and renal impairment and was diagnosed with primary FSGS after kidney biopsy, which showed a segmental scar with diffuse effacement of foot processes on electron microscopy. Treatment with steroids reduced proteinuria and stabilized the renal function. A few months later, the patient presented with acute Kidney Injury, bone pain, and anemia. A diagnosis of MM was made based on the bone marrow biopsy. Treatment of MM decreased proteinuria and improved renal function.Conclusions:There is an association between FSGS and MM through an unclear mechanism.

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“…integrin on glomerular podocytes, leading to foot process (FP) effacement and proteinuria (10)(11)(12)(13)(14).…”

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confidence: 99%

Truncated suPAR simultaneously causes kidney disease and autoimmune diabetes mellitus

Zhu

Mukherjee

Wei

et al. 2022

Preprint

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Soluble urokinase-type plasminogen activator receptor (suPAR) is a risk factor for kidney diseases. Here we report the presence of C-terminal suPAR fragment, D2D3, in patients with diabetic nephropathy. D2D3-positive human sera inhibited glucose-stimulated insulin release in human islets and were associated with patients requiring insulin therapy. D2D3 transgenic mice presented kidney disease and diabetes marked by decreased levels of insulin and C-peptide, impaired glucose-stimulated insulin secretion, decreased pancreatic β-cell mass, and high fasting glucose. D2D3 fragment dysregulated glucose-induced cytoskeletal dynamics, impaired maturation and trafficking of insulin granules, and inhibited bioenergetics of β-cells in culture. An anti-uPAR antibody restored β-cell function in D2D3 transgenic mice. We show that the D2D3 fragment injures the kidney and pancreas, offering a unique dual therapeutic approach for kidney diseases and insulin-dependent diabetes.SummaryProteolytic suPAR fragment, D2D3, simultaneously injures two organs, the kidney and pancreas, thus causing a dual organ disease.

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Multiple myeloma with a previous diagnosis of focal segmental glomerulosclerosis: A case report and review of the literature

Cited by 3 publications

References 17 publications

Crystalline deposits in the cornea and various areas of the kidney as symptoms of an underlying monoclonal gammopathy: a case report

Crystalline deposits in the cornea and various areas of the kidney as symptoms of an underlying monoclonal gammopathy: a case report

Multiple Myeloma in a Patient with Focal Segmental Glomerulosclerosis: A Case Report

Truncated suPAR simultaneously causes kidney disease and autoimmune diabetes mellitus

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