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A 36-year-old female was referred with renal impairment, creatinine clearance 0.4 mL/s and proteinuria 4.7 g/day. Physical examination was unremarkable. Biochemistry showed normochromic normocytic anaemia, slight hypoalbuminaemia and hypercalcaemia. Anti-neutrophil cytoplasmic antibodies, anti-nuclear antibodies, anti-glomerular basement membrane, anti-phospholipid antibodies, and viral screening were negative. IgG-kappa M-protein was found in plasma (4.8 g/L) and urine (<0.02 g/L), while plasma immunoglobulins and liver enzymes were normal. Bone marrow, skeleton scintigraphy and MR scan were normal. An ultrasound showed normal-sized kidneys. Kidney biopsy presented focal interstitial nephritis, light grade

Multiple myeloma in a kidney transplanted patient primarily diagnosed with monoclonal gammopathy of unknown significance (MGUS)-related nephropathy