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Development of rapidly progressive liver light chain deposition under VAD chemotherapy in multiple myeloma
Author(s) -
Samanez César,
Domingo Abel,
Cibeira Ma Teresa,
Miquel Rosa,
Soler Manel,
Bladé Joan
Publication year - 2006
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2005.00561.x
Subject(s) - amyloidosis , medicine , pathology , immunoglobulin light chain , nephrotic syndrome , al amyloidosis , multiple myeloma , vincristine , eosinophilic , plasma cell dyscrasia , chemotherapy , gastroenterology , immunology , antibody , cyclophosphamide
Light chain deposition disease (LCDD) is a multisystemic disorder seen in the setting of plasma cell dyscrasias. The histological characteristic of this disorder is the deposition of a homogeneous, granular, slightly eosinophilic and non‐Congophilic material that shows immunostaining for monoclonal light chains ( κ or γ ), while in primary amyloidosis (AL) the proteinaceous substance is fibrillar and Congo red positive. In contrast with AL, the light chain in LCDD is usually of the κ ‐type. Renal involvement, resulting in nephrotic syndrome, is usually the prominent feature of LCDD. Patients with this disease may also have heart, liver or other organ involvement, mimicking the picture of primary systemic amyloidosis. However, liver failure has rarely been described in patients with LCDD. A patient with myeloma‐associated LCDD who developed rapidly progressive liver κ light chain deposition with fatal outcome after undergoing the first cycle of vincristine/doxorubicin/dexamethasone chemotherapy is reported.