An interesting case of multiple myeloma with renal monoclonal immunoglobulin deposition disease – A case report

Abstract

B-cell proliferative disorders may display the pathogenic effects by increased cell numbers, increased concentration of the molecules produced by these cells or both. Most forms of renal disease associated with monoclonal gammaglobulinopathy results from deposition of monoclonal immunoglobulins or their subunits in different compartment of kidney. Renal monoclonal immunoglobulin deposition disease (MIDD) is defined by deposits of monoclonal light chain components in renal basement membrane, mesangium which often produces a nodular sclerosing glomerulopathy. Clinical features of renal MIDD include proteinuria with or without renal failure with dysproteinemias.

We describe one case of a 68 years old male presenting with swelling with heavy proteinuria and advanced azotaemia whose renal biopsy showed nodular glomerulosclerosis. The patient had features of multiple myeloma as he had bony lytic lesions, M-spike in urine electrophoresis and plasma cells in bone marrow biopsy and elevated β2 microglobulin level.