• Internal medicine · Jun 2024

    Case Reports

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

    • Toshiya Nishigaito, Kensuke Mitsumoto, Rinko Katsunuma, Yuri Hirai, Chikako Yamashita, Aya Mizumoto, and Takashi Uzu.
    • Department of Nephrology, Nippon Life Hospital, Japan.
    • Intern. Med. 2024 Jun 15; 63 (12): 175117551751-1755.

    AbstractThe 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.

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