Crystalline Light Chain Casts and Hypercalcemia Induced Acute Kidney Injury: A Rare Presentation of Multiple Myeloma

The most common cause of acute kidney injury (AKI) in multiple myeloma is light-chain cast nephropathy (LCCN), which consists of a light chain and Tamm-Horsfall protein (THP). We herein report a 46-year-old woman with hypercalcemia and AKI. A renal biopsy showed crystalline casts, which were consist...

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Published in:Internal Medicine 2024/06/15, Vol.63(12), pp.1751-1755
Main Authors: Nishigaito, Toshiya, Mitsumoto, Kensuke, Katsunuma, Rinko, Hirai, Yuri, Yamashita, Chikako, Mizumoto, Aya, Uzu, Takashi
Format: Article
Language:English
Subjects:
Acute Kidney Injury - diagnosis
Acute Kidney Injury - etiology
Biopsy
Bortezomib
Bortezomib - therapeutic use
Calcium (blood)
cast nephropathy
crystalline cast
Crystallization
Female
Humans
Hypercalcemia
Hypercalcemia - blood
Hypercalcemia - diagnosis
Hypercalcemia - etiology
Immunoglobulin Light Chains - blood
Kidneys
Light chains
Middle Aged
Multiple myeloma
Multiple Myeloma - complications
Multiple Myeloma - diagnosis
Nephropathy
Tamm-Horsfall protein
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container_end_page 1755
container_issue 12
container_start_page 1751
container_title Internal Medicine
container_volume 63
creator Nishigaito, Toshiya
Mitsumoto, Kensuke
Katsunuma, Rinko
Hirai, Yuri
Yamashita, Chikako
Mizumoto, Aya
Uzu, Takashi
description The most common cause of acute kidney injury (AKI) in multiple myeloma is light-chain cast nephropathy (LCCN), which consists of a light chain and Tamm-Horsfall protein (THP). We herein report a 46-year-old woman with hypercalcemia and AKI. A renal biopsy showed crystalline casts, which were consistent with lambda light chains but not THP. Hydration therapy and treatment to lower her serum calcium concentration were initiated immediately. She subsequently received bortezomib-based anti-myeloma therapy and recovered successfully. This was a rare case of LCCN, suggesting that hypercalcemia may play a role in the development of crystalline LCCN.
doi_str_mv 10.2169/internalmedicine.2603-23
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subjects Acute Kidney Injury - diagnosis
Acute Kidney Injury - etiology
Biopsy
Bortezomib
Bortezomib - therapeutic use
Calcium (blood)
cast nephropathy
crystalline cast
Crystallization
Female
Humans
Hypercalcemia
Hypercalcemia - blood
Hypercalcemia - diagnosis
Hypercalcemia - etiology
Immunoglobulin Light Chains - blood
Kidneys
Light chains
Middle Aged
Multiple myeloma
Multiple Myeloma - complications
Multiple Myeloma - diagnosis
Nephropathy
Tamm-Horsfall protein
title Crystalline Light Chain Casts and Hypercalcemia Induced Acute Kidney Injury: A Rare Presentation of Multiple Myeloma
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