Recurrent light and heavy chain deposition disease after renal transplantation

Light and heavy chain deposition disease (LHCDD) is a rare entity with less than two dozen reported cases [1,2]. The term LHCDD was proposed in 1984 as a variant of light chain deposition disease (LCDD), to characterize a subset of patients in whom deposits contain both light and heavy chain antigenic determinants. We present a case of LHCDD in a renal graft and evidence that this process represented disease recurrence. This case illustrates how difficult LHCDD can be to diagnose. The patient’s post-transplant course suggests that LHCDD may recur in transplanted kidneys, and may evolve into multiple myeloma and AL-amyloidosis.