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myeloma cast nephropathy

Meera Mohan, Amy Buros, Pankaj Mathur, Neriman Gokden, Manisha Singh, Sandra Susanibar, Jorge Jo Kamimoto, Shadiqul Hoque, Muthukumar Radhakrishnan, Aasiya Matin, Cynthia Davis, Monica Grazziutti, Sharmilan Thanendrarajan, Frits van Rhee, Maurizio Zangari, Faith Davies, Gareth Morgan, Joshua Epstein, Bart Barlogie, Carolina Schinke
Light chain deposition disease (LCDD) is characterized by monotypic immunoglobulin depositions which will eventually lead to loss of organ function if left untreated. While the kidney is almost always affected, the presence and degree of LCDD in other organs vary. Ten to 30% of LCDD patients have underlying Multiple Myeloma (MM), yet outcome and prognostic markers in this particular patient group are still lacking. Here, we analyzed 69 patients with MM and biopsy proven LCDD and report on renal and extra-renal involvement and its impact on prognosis as well as renal response depending on hematologic response...
April 6, 2017: American Journal of Hematology
Kim Dao, Yimin Lu, Cody J Peer, William D Figg, Raphael Stadelmann, Michel Burnier, Thierry Buclin, Sebastien Kissling
INTRODUCTION: High cut-off dialysis, increasingly used in multiple myeloma patients, is susceptible to influence anticancer drug elimination. We report about lenalidomide disposition in a patient on high cut-off dialysis for renal failure secondary to myeloma cast nephropathy. METHODS: The patient received a higher dosage of lenalidomide (5 mg b.i.d.), owing to concerns about a potential decrease in lenalidomide exposure during dialysis sessions. A set of blood samples was taken in order to develop a pharmacokinetic model accounting for lenalidomide concentrations in this setting...
December 17, 2016: Cancer Chemotherapy and Pharmacology
P Fabbrini, K Finkel, M Gallieni, G Capasso, M Cavo, A Santoro, S Pasquali
Acute kidney injury (AKI) is a frequent complication of multiple myeloma and is associated with increased short-term mortality. Additionally, even a single episode of AKI can eventually lead to end-stage renal disease (ESRD), significantly reducing quality of life and long-term survival. In the setting of multiple myeloma, severe AKI (requiring dialysis) is typically secondary to cast nephropathy (CN). Renal injury in CN is due to intratubular obstruction from precipitation of monoclonal serum free light chains (sFLC) as well as direct tubular toxicity of sFLC via stimulation of nuclear factor (NF)κB inflammatory pathways...
December 2016: Journal of Nephrology
Maria Gavriatopoulou, Evangelos Terpos, Efstathios Kastritis, Meletios A Dimopoulos
Renal impairment (RI) is one of the most common complication of multiple myeloma (MM). RI is present in almost 20% of MM patients at diagnosis and in 40%-50% of patients during the course of their disease. Areas covered: Biology along with tools for diagnosis and management of RI are reported in this paper. Papers published in PubMed and reported abstracts up to May 2016 were used. Expert opinion: Moderate and severe RI increases the risk of early death; thus rapid intervention and initiation of anti-myeloma treatment is essential and improves renal outcomes in RI patients...
November 2016: Expert Opinion on Pharmacotherapy
Punit Yadav, Mark Cook, Paul Cockwell
BACKGROUND: Renal impairment (RI) is a common complication of multiple myeloma (MM). Around 50% of patients with MM have RI at presentation, and up to 5% require dialysis treatment. Severe acute kidney injury (AKI) as a cause of RI is a particular challenge as historically the survival of patients who sustain this complication and require dialysis is very poor. However, in this current period, survival is improving and the focus is on optimum use of novel chemotherapies and the evaluation of extra-corporeal therapies for removal of serum immunoglobulin light chains...
March 2016: Kidney Diseases
Kevin W Finkel, Eric P Cohen, Anushree Shirali, Ala Abudayyeh
Nearly 50% of patients with multiple myeloma develop renal disease, most commonly from AKI caused by cast nephropathy. Development of AKI is associated with poor 1-year survival and reduces the therapeutic options available to patients. There is a great need for more effective therapies. Cast nephropathy is caused by the interaction and aggregation of filtered free light chains and Tamm-Horsfall protein causing intratubular obstruction and damage. The key to treating cast nephropathy is rapid lowering of free light chains, because this correlates with renal recovery...
December 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Sumit Grover, Pavneet Kaur Selhi, Neena Sood, Jasvinder Singh Sandhu, Harpreet Kaur
Multiple myeloma is a disorder of plasma cells which can involve kidneys in the form of cast nephropathy. Neoplastic plasma cells produce either complete immunoglobulins or fragments of immunoglobulins leading to a monoclonal spike in the serum and/or Bence Jones proteinuria. Very few patients present as non-secretory myeloma when no immunoglobulins (M spike) are produced or only light chains are secreted which can only be detected in urine. Acute renal failure due to cast nephropathy can rarely be the first presentation of multiple myeloma...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Adriano Curti, Albin Schwarz, Johannes Trachsler, Yuki Tomonaga, Patrice M Ambühl
BACKGROUND: High Cut-Off (HCO) dialysis membranes efficiently reduce serum free light chain (FLC) concentrations and may improve renal recovery and survival from multiple myeloma (MM) associated renal failure with cast nephropathy. However, clinical trials comparing dialysis with HCO versus conventional filters are lacking. The aim of this study was to assess clinical outcomes and economic impact of HCO dialyzers compared to conventional hemodialysis membranes in cast nephropathy. METHODS: Multicenter retrospective analysis of 19 patients treated for renal failure from FLC associated cast nephropathy with standard induction chemotherapy (bortezomib/dexamethasone)...
2016: PloS One
Disha Arora, Mayank Uppal, Vindu Amitabh, Usha Agrawal
Light Chain Deposition Disease (LCDD) is a rare disease characterized by deposition of monoclonal non-amyloid light chains in multiple organs. We report an unusual histologic manifestation of LCDD in a 55-year-old female patient, who presented with nephrotic syndrome and an increased serum creatinine. This case of LCDD had features of cast nephropathy on biopsy which is diagnostic of myeloma kidney, when the patient was clinically asymptomatic. Serum electrophoresis showed no abnormal band. There was no other evidence of a B-cell clonal disorder or amyloidosis...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
Mathini Jayaballa, Bhadran Bose, Muralikrishna Gangadharan Komala, Eddy Ronald Fischer, John Taper, Kamal Sud
No abstract text is available yet for this article.
2016: Blood Purification
Ana Berni Wennekers, María Pilar Martín Azara, Victoria Dourdil Sahun, Beatriz Bergasa Liberal, José Esteban Ruiz Laiglesia, Patricia Vernet Perna, Rafael Alvarez Lipe
INTRODUCTION: Multiple myeloma (MM) is a haematological tumour that is characterised by uncontrolled proliferation of plasma cells and a significant volume of serum free light chains (sFLCs), which can cause acute renal failure due to intratubular precipitation, resulting in cast nephropathy. Acute renal failure is a complication that can arise in more than 20% of patients with multiple myeloma, half of which will require dialysis. METHODS: We report our experience with 13 patients who were treated with dialysis using high cut off filters (HCO) between July 2011 and February 2015...
July 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Imen Gorsane, S Barbouch, M Mayara, K Ben Abdelghani, R Goucha, F Ben Hamida, H Hedri, T Ben Abdallah
To determine the features of the different forms of kidney diseases associated with multiple myeloma (MM), we retrospectively studied 144 patients with kidney injury and MM at our institute from 1974 to 2014. The mean age of the patients was 60.1 years and the male:female ratio was 1.25. Renal disease was concomitant with the discovery of MM in 92% of cases. The mean follow-up of our patients was 2.1 years. Initial renal insufficiency was found in 131 (91%) patients. Cast nephropathy of the distal tubule was found in 110 (26%) patients, renal amyloidosis in 16 (11...
May 2016: Saudi Journal of Kidney Diseases and Transplantation
Małgorzata Kościelska, Maciej Graczyk
Monoclonal gammopathies are a group of diseases caused by proliferation of a single clone of plasmocytes - or lymphoplasmacytic cells producing a monoclonal protein. Renal failure occurs in 20-50% of the patients with multiple myeloma, with myeloma cast nephropathy being its major cause. The other mechanisms of kidney injury include hypercalcemia, AL amyloidosis, light chain deposition disease and others. Patients who develop renal impairment have worse survival than those with normal kidney function. This article discusses the pathogenesis, evaluation and therapy of the renal diseases due to monoclonal gammopathies...
2015: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Yu-Tai Su, Xin-Sheng Xie, Hui Sun, Jie Ma, Ding-Ming Wan, Yan-Fang Liu
OBJECTIVE: To explore the clinical features of multiple myeloma with different renal pathology, and to evaluate its prognosis. METHODS: Clinical features and prognosis of 46 multiple myeloma patients with different renal pathology were analyzed retrospectively. According to renal pathology, the 46 patients were divided into 3 groups: cast nephropathy (24 cases), amyloidosis (15 cases) and other type (7 cases). RESULTS: By durie-Salmon staging system, 70...
April 2016: Zhongguo Shi Yan Xue Ye Xue za Zhi
Helen Liapis, Christie Boils, Randolph Hennigar, Fred Silva
Five hundred eighty renal biopsies from a pool of 27850 archived cases were identified in which a myoglobin stain was performed because of atypical casts. Two hundred and thirty-eight (41%) of these biopsies were found to be positive for myoglobin casts. The morphology of the myoglobin casts ranged from light, almost translucent and refractile, to pink, to dark red and slightly brown granular casts by hematoxylin and eosin, to beaded globular casts that stained brightly fuchsinophilic with Masson trichrome and partially argyrophilic with silver methenamine...
August 2016: Human Pathology
Benoit Brilland, Johnny Sayegh, Anne Croue, Frank Bridoux, Jean-François Subra, Jean-François Augusto
Light chain deposition disease (LCDD) is a rare multisystemic disorder associated with plasma cell proliferation. It mainly affects the kidney, but liver and heart involvement may occur, sometimes mimicking the picture of systemic amyloidosis. Liver disease in LCDD is usually asymptomatic and exceptionally manifests with severe cholestatic hepatitis. We report the case of a 66-year-old female with κ-LCDD and cast nephropathy in the setting of symptomatic multiple myeloma who, after a first cycle of bortezomib-dexamethasone chemotherapy, developed severe and rapidly worsening intrahepatic cholestasis secondary to liver κ-light chain deposition...
March 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
Lavjay Butani, Jonathan Ducore
Cast nephropathy is the most common manifestation of renal injury in patients with multiple myeloma but is rarely reported in other conditions. We are reporting our experience in caring for a teenager with a metastatic neuroendocrine carcinoma who developed rapidly progressive kidney injury that advanced to end-stage renal disease. On renal biopsy extensive tubular necrosis and intratubular eosinophilic casts were noted. This previously unreported finding should prompt oncologists to closely monitor for such a complication in patients with secretory tumors...
July 2016: Journal of Pediatric Hematology/oncology
Laure Ecotière, Antoine Thierry, Céline Debiais-Delpech, Sylvie Chevret, Vincent Javaugue, Estelle Desport, Simohamed Belmouaz, Nathalie Quellard, Sihem Kaaki, Jean Michel Goujon, Jean-Paul Fermand, Guy Touchard, Frank Bridoux
No abstract text is available yet for this article.
May 2016: Nephrology, Dialysis, Transplantation
Eleonora Plotkin, Sydney Benchetrit, Tanya Zahavi, Oded Kimhi, Ze'ev Korzets
No abstract text is available yet for this article.
December 2015: Israel Medical Association Journal: IMAJ
Sanjeev Sethi, Fernando C Fervenza, S Vincent Rajkumar
PURPOSE OF REVIEW: Monoclonal gammopathies result from an overt malignant process, such as multiple myeloma, or a premalignant process, such as monoclonal gammopathy of undetermined significance. The kidney is often affected in the setting of a monoclonal gammopathy. The term 'monoclonal gammopathy of renal significance (MGRS)' was recently introduced to draw attention to renal diseases related to the monoclonal gammopathy. In this review, we define the pathology of these monoclonal gammopathy-associated kidney diseases...
March 2016: Current Opinion in Nephrology and Hypertension
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