Open AccessNon-Secretory Myeloma, Diagnosed on Renal Biopsy as Cast Nephropathy
Author(s) -
Sumit Grover,
Pavneet Kaur Selhi,
Neena Sood,
Jeet Sandhu,
Harpreet Kaur
Publication year - 2016
Publication title -
journal of clinical and diagnostic research
Language(s) - English
Resource type - Journals
eISSN - 2249-782X
pISSN - 0973-709X
DOI - 10.7860/jcdr/2016/19060.7925
Subject(s) - bence jones protein , multiple myeloma , medicine , renal biopsy , pathology , bone marrow , plasma cell , biopsy , proteinuria , nephropathy , antibody , immunoglobulin light chain , kidney , immunology , endocrinology , diabetes mellitus
Multiple myeloma is a disorder of plasma cells which can involve kidneys in the form of cast nephropathy. Neoplastic plasma cells produce either complete immunoglobulins or fragments of immunoglobulins leading to a monoclonal spike in the serum and/or Bence Jones proteinuria. Very few patients present as non-secretory myeloma when no immunoglobulins (M spike) are produced or only light chains are secreted which can only be detected in urine. Acute renal failure due to cast nephropathy can rarely be the first presentation of multiple myeloma. We here in report a case in which primary diagnosis of multiple myeloma was made on renal biopsy due to its characteristic histomorphology. The diagnosis was later on supported by presence of neoplastic plasma cells in the aspirate and biopsy of bone marrow.