Paraneoplastic Cast Nephropathy Associated With Pancreatic Mixed Acinar-Neuroendocrine Carcinoma: A Case Report

Paraneoplastic REG1α Cast Nephropathy Associated With Mixed Acinar-Neuroendocrine Carcinoma

“…Our patient and the three previously reported patients with ACC/MANC-associated paraneoplastic cast nephropathy 2,8,9 did not recover kidney function; thus renal prognosis appears to be dismal, reflecting the aggressive tumor behavior and poor patient outcome. Kidney biopsy should be considered in patients with acute kidney injury and recent diagnosis of pancreatic ACC, MANC, or neuroendocrine carcinoma (which can resemble MANC morphologically), to exclude paraneoplastic cast nephropathy.…”

“…8,9 We recently reported a third case of myeloma-like cast nephropathy in association with MANC in which proteomic analysis and IHC identified two acinar-cell specific proteins, REG1α and CPA1 in tubular casts and tumor cells. 2 In the patient described here, very large J o u r n a l P r e -p r o o f numbers of protein spectra for REG1α were detected in the atypical casts by proteomic analysis with strong staining for REG1 by IHC, consistent with paraneoplastic REG1 cast nephropathy.…”

“…A previously described procedure was utilized to characterize the proteomic content of the renal casts and tumor cells. 2 Casts were laser microdissected from a 10μm-thick kidney section of paraffin embedded necropsy specimen. Two independent dissections were collected, and the proteins present were processed and subjected to mass spectrometry analysis using a previously described protocol.…”

N6-methyladenosine modification of REG1α facilitates colorectal cancer progression via β-catenin/MYC/LDHA axis mediated glycolytic reprogramming

“…Geng et al reported that REG1α could be used as a marker of prognosis and recurrence in bladder cancer, and downregulation of REG1α reduced tumor growth, migration, invasion and angiogenesis [ 25 ]. Nasr et al found that REG1α was highly expressed in both tubular casts and tumor cells in a patient with pancreatic acinar-neuroendocrine carcinoma [ 26 ]. Besides, in primary gastric epithelial cells, helicobacter and gastrin stimulated the expression of REG1α and accelerated the progression of gastric cancer [ 27 ].…”

Management of acute kidney injury in symptomatic multiple myeloma

“…92 Cast formation can be observed in patients with pancreatic acinar or mixed acinar neuroendocrine carcinoma. 93 In these situations, immunofluorescence studies are determinant by showing the absence of LC restriction.…”