Kidney Res Clin Pract.  2016 Dec;35(4):259-262. 10.1016/j.krcp.2016.06.001.

Crystalline podocytopathy and tubulopathy without overt glomerular proteinuria in a patient with multiple myeloma

• Lee EJ
• Lee SY
• Park SY
• Kim Y
• Choi JS
• Kim MJ
• Park JH
• Lee JE
• Kwon GY
• Kim YG

• KMID: 2364293
• DOI: http://doi.org/10.1016/j.krcp.2016.06.001

Abstract

Crystalline nephropathy is a rare yet well-known condition associated with multiple myeloma and other light chain-secreting disorders. Paraproteins that are resistant to proteolysis crystallize within proximal tubular cells and cause light-chain proximal tubulopathy, which presents clinically as Fanconi syndrome. Podocytes are rarely affected, and the crystalline inclusions within podocytes are typically precipitated, yielding significant glomerular proteinuria. Here we report a case of extensive crystalline inclusions primarily within podocytes and proximal tubules that presented only with Fanconi syndrome and renal insufficiency. Despite the presence of extensive crystalline inclusions in podocytes and diffuse foot process effacement, the patient had no clinical evidence suggestive of podocyte injury.

Keyword

Fanconi syndrome; Multiple myeloma; Nephropathy

MeSH Terms

Crystallins*
Fanconi Syndrome
Foot
Humans
Multiple Myeloma*
Paraproteins
Podocytes
Proteinuria*
Proteolysis
Renal Insufficiency
Crystallins
Paraproteins