Kidney Res Clin Pract.
2014 Jun;33(2):112-115.
A case of Fanconi syndrome accompanied by crystal depositions in tubular cells in a patient with multiple myeloma
- Affiliations
-
- 1Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 2Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jungeun34.lee@samsung.com
- 3Division of Hematology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 4Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
- Fanconi syndrome (FS) is a rare condition that is characterized by defects in the proximal tubular function. A 48-year-old woman was admitted for evaluation of proteinuria. The patient showed normal anion gap acidosis, normoglycemic glycosuria, hypophosphatemia, and hypouricemia. Thus, her condition was compatible with FS. The M peak was found behind the beta globulin region in urine protein electrophoresis. Upon bone marrow examination, we found that 24% of cells were CD138+ plasma cells with kappa restriction. From a kidney biopsy, we found crystalline inclusions within proximal tubular epithelial cells. Thereafter, she was diagnosed with FS accompanied by multiple myeloma. The patient received chemotherapy and autologous stem cell transplantation, and obtained very good partial hematologic response. However, proximal tubular dysfunction was persistent until 1 year after autologous stem cell transplantation. In short, we report a case of FS accompanied by multiple myeloma, demonstrating crystalline inclusion in proximal tubular cells on kidney biopsy.
MeSH Terms
-
Acid-Base Equilibrium
Acidosis
Beta-Globulins
Biopsy
Bone Marrow Examination
Crystallins
Drug Therapy
Electrophoresis
Epithelial Cells
Fanconi Syndrome*
Female
Glycosuria
Humans
Hypophosphatemia
Immunoglobulin kappa-Chains
Kidney
Middle Aged
Multiple Myeloma*
Plasma Cells
Proteinuria
Stem Cell Transplantation
Beta-Globulins
Crystallins
Immunoglobulin kappa-Chains
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