Open AccessRapidly progressive immunoglobulin M monoclonal gammopathy presenting with nephrotic syndrome and hepatic failure
Author(s) -
Yao-Ko Wen
Publication year - 2020
Publication title -
saudi journal of kidney diseases and transplantation/našrat amraḍ wa zira'aẗ al-kulaẗ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.268
H-Index - 30
eISSN - 2320-3838
pISSN - 1319-2442
DOI - 10.4103/1319-2442.308354
Subject(s) - hypergammaglobulinemia , medicine , nephrotic syndrome , jaundice , pathology , amyloidosis , gammopathy , immunoglobulin m , waldenstrom macroglobulinemia , acute kidney injury , gastroenterology , immunology , monoclonal , disease , antibody , immunoglobulin g , monoclonal antibody , lymphoma
We report a 73-year-old male with no relevant past medical history who presented with nephrotic syndrome and jaundice. Subsequent studies revealed immunoglobulinM (IgM) monoclonal gammopathy. Kidney biopsy revealed monoclonal Ig deposition disease and amyloidosis. Bone marrow biopsy demonstrated <10% infiltration by lymphoplasmacytic cells. However, rapidly progressive hypergammaglobulinemia of IgM and hyperbilirubinemia were noted. Despite aggressive treatment, the patient developed acute kidney injury and complications of hepatic failure. He eventually died of pneumonia, just two months after diagnosis.