Waldenström Macroglobulinemia: Unusual Presentation With Cast Nephropathy/Light Chain Tubulopathy

Clinical Medicine Insights. Case Reports
Muddasir Ashraf, Prerna Rastogi

Abstract

Cast Nephropathy/Light chain tubulopathy is usually present in patients with multiple myeloma and is very rare in patients with Waldenstrom Macroglobulinemia. There are very few case reports mentioned in the literature. We present an interesting case of Cast Nephropathy and light chain tubulopathy in an 81-year-old female patient with Waldenstrom Macroglobulinemia who required medical attention for worsening renal failure. Serum protein electrophoresis/Immunofixation showed IgM Kappa monoclonal gammopathy. Renal biopsy was remarkable for cast nephropathy and light chain tubulopathy. Furthermore on bone marrow biopsy a low grade B cell lymphoproliferative disorder with plasmacytic differentiation was present. This was most consistent with lymphoplasmacytic lymphoma, accounting for 50-60 percent of total bone marrow cellularity, in a hypercellular (60-80 percent) bone marrow.

References

Jan 17, 2003·Mayo Clinic Proceedings·Robert A KylePhilip R Greipp
Apr 29, 2003·Cancer Metastasis Reviews·Michael BenjaminOtis W Brawley
Oct 29, 2014·American Journal of Hematology·Ranjit BanwaitIrene M Ghobrial
Jul 30, 2016·British Journal of Haematology·Josephine M VosJorge J Castillo
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Methods Mentioned

BETA
electrophoresis
biopsy
electron microscopy

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