Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
IgA-kappa Type Multiple Myeloma Affecting Proximal and Distal Renal Tubules
Kesami MINEMURAKazuo ICHIKAWANobuo ITOHNaomi SUZUKIMasahiro HARASatoshi SHIGEMATSUHiroaki KOBAYASHIKunihide HIRAMATSUKiyoshi HASHIZUME
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2001 Volume 40 Issue 9 Pages 931-935

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Abstract

A 45-year-old male was admitted because of chest pain, lumbago, and bilateral ankle pain. Examination disclosed hypophosphatemic osteomalacia, acquired Fanconi syndrome, and abnormalities in distal nephron such as distal renal tubular acidosis and renal diabetes insipidus. Further exploration revealed IgA kappa multiple myeloma excreting urinary Bence Jones protein (kappa-light chain). Renal biopsy revealed thick basement membranes and electron-dense crystals in proximal tubular epithelial cells. Immunofluorescent studies revealed deposition of kappalight chain in renal tubular epithelial cells that caused the renal tubular damage. Although the osteomalacia was relieved by medical treatment, the urinary Bence Jones protein and the renal tubular defects were not improved by the chemotherapy for the myeloma. The patient died of exacerbation of multiple myeloma at 50 years of age.
(Internal Medicine 40: 931-935, 2001)

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