Download - U06-11469
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U06-11469
#426820800
• Native (L) kidney
• Proteinuria
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U06-11469
• 59 year old Caucasian male
• no significant past medical history; normal u/a Nov 2002 and ?July 2003 (1+ protein on highly concentrated urine)
• presented in December 2005 with new onset of peripheral edema; no renal work-up performed at that time
• found to have nephrotic syndrome May 2006; serum albumin 28 g/L
• work-up revealed serum creatinine of 88 µM with urine protein/creatinine ratio of 683 – 860 mg/mmol, negative hepatitis serology, no diabetes, normal complements, negative dsDNA, serum PEP=nephrotic syndrome, urine PEP=free lambda light chain
• bone marrow Bx did not meet criteria for diagnosis of multiple myeloma
• renal Bx results…
• remainder of investigations…..
• plan…..
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IF
• No glomeruli are seen
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10 nm mean diameter
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Diagnosis
Renal Biopsy:Renal amyloidosis in an early stage with relatively small amounts of amyloid deposited and few changes by light microscopy.
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U06-11469
• 59 year old Caucasian male
• no significant past medical history; normal u/a Nov 2002 and ?July 2003 (1+ protein on highly concentrated urine)
• presented in December 2005 with new onset of peripheral edema; no renal work-up performed at that time
• found to have nephrotic syndrome May 2006; serum albumin 28 g/L
• work-up revealed serum creatinine of 88 µM with urine protein/creatinine ratio of 683 – 860 mg/mmol, negative hepatitis serology, no diabetes, normal complements, negative dsDNA, serum PEP=nephrotic syndrome, urine PEP=free lambda light chain
• bone marrow Bx did not meet criteria for diagnosis of multiple myeloma
• renal Bx revealed amyloidosis
• remainder of investigations revealed cardiac amyloid with spickling and thickening of myocardium…..; normal function
• plan autologous stem cell transplant mid-September