Korean J Med.  2015 Mar;88(3):318-323. 10.3904/kjm.2015.88.3.318.

A Case of Light Chain Deposition Disease in a Patient with Diabetes and Nodular Glomerulosclerosis

• Lee KH
• Kang SH
• Lee HW
• Park GE
• Hong YS
• Lee JE
• Kim YG

• KMID: 2082594
• DOI: http://doi.org/10.3904/kjm.2015.88.3.318

Abstract

A 50 year-old male with a 10-year history of diabetes was admitted to the hospital for edema and foamy urine. At the time of admission, serum creatinine was 1.99 mg/dL and 24 h urine protein levels were 4.0 g/day. Renal biopsy showed nodular glomerulosclerosis. Immunofluorescence demonstrated the presence of kappa light chains along the glomerular and tubular basement membrane. Electron microscopy showed granular electron-dense deposits along the glomerular subendothelium and tubular basement membrane. Serum protein electrophoresis was negative for a monoclonal spike; however, urine protein electrophoresis demonstrated a monoclonal spike. Bone marrow examination was compatible with multiple myeloma and the patient was diagnosed with light-chain deposition disease associated with multiple myeloma. This report stresses the significant challenges that occur when diagnosing light-chain deposition disease in kidneys of patients with long standing diabetes, and discusses previously reported cases of light-chain deposition disease in Korea.

Keyword

Immunoglobulin light chains; Diabetic nephropathies; Multiple myeloma

MeSH Terms

Basement Membrane
Biopsy
Bone Marrow Examination
Creatinine
Diabetic Nephropathies*
Edema
Electrophoresis
Fluorescent Antibody Technique
Humans
Immunoglobulin Light Chains
Kidney
Korea
Male
Microscopy, Electron
Multiple Myeloma
Creatinine
Immunoglobulin Light Chains