Non-amyloid deposits glomerulopathy with multiple myeloma; a rare presentation

Lien externe
Disciplines associéesAnatomie Pathologique
AuteurAlaoui sekkouri K
Auteurs associésBatta FZ, Alaoui-Belghiti K, Alaoui H, Hadj sadek B, Arrayhani M, Harmouch T, Sqalli houssaini T
RevueImmunopathologia Persa
Référence Revue2(1):e08

Renal complications in multiple myeloma are common. The occurrence of non-amyloid deposits glomerulopathy is rare. We report an exceptional non-amyloid deposits glomerulopathy in a patient followed for multiple myeloma in complete remission. A 70-year-old male patient, followed for lambda light chains multiple myeloma, and treated according to the protocol
Alexanian with a complete remission at the end of treatment. After one year of follow-up, a deep pure nephrotic syndrome occurred. Renal biopsy was then conducted. It included 10 glomeruli, all with pseudo-amyloid deposits, amorphous and stifling tuft. Congo-red was negative. Immunofluorescence objectified a glomerular and mesangial intense, diffuse and global IgG deposits. The electron microscopic examination was not conducted. Kidney damage in multiple myeloma include tubulointerstitial nephropathy and immunoglobulin glomerulopathy, which amyloidosis deposits and Randall syndrome. The clinic context, as well as the appearance in optical microscopy of renal fragment moving towards renal amyloidosis. Paradoxically, the Congo-red staining was negative, in favor to a non-amyloid deposits glomerulopathy. An electron microscopic examination is needed to highlight the fibrillar or microtubular deposits.
The occurrence of non-amyloid deposits glomerulopathy in multiple myeloma is exceptional. The study by light microscopy, immunofluorescence and electron microscopy especially makes it easy to diagnose