Andrea Angioi, Nicola Lepori, Matteo Floris, Wisit Cheungpasitporn, Paola Bianco, Gianfranca Cabiddu, Antonello Pani
{"title":"复发急性肾小管间质性肾炎表现为Kappa轻链多发性骨髓瘤1例。","authors":"Andrea Angioi, Nicola Lepori, Matteo Floris, Wisit Cheungpasitporn, Paola Bianco, Gianfranca Cabiddu, Antonello Pani","doi":"10.1159/000544930","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Light chain-mediated acute tubulointerstitial nephritis (LCTIN) is a rare and underrecognized renal manifestation of plasma cell dyscrasias, including multiple myeloma. It presents as a dense interstitial inflammatory infiltrate involving polyclonal lymphocytes and plasma cells, often mimicking other forms of tubulointerstitial nephritis and delaying the correct diagnosis.</p><p><strong>Case presentation: </strong>A 46-year-old man was initially managed as having drug-induced acute interstitial nephritis due to NSAID use, responding only transiently to steroids. Upon relapse with worsening kidney function, hypercalcemia, and systemic symptoms, a second kidney biopsy demonstrated again an intense tubulointerstitial infiltrate and κ-light chain proximal tubulopathy.</p><p><strong>Conclusion: </strong>This case illustrates that LCTIN can mimic relapsing interstitial nephritis. Early recognition and appropriate plasma cell-targeted therapy may significantly improve renal outcomes and guide clinical management.</p>","PeriodicalId":9599,"journal":{"name":"Case Reports in Nephrology and Dialysis","volume":"15 1","pages":"170-176"},"PeriodicalIF":0.9000,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342701/pdf/","citationCount":"0","resultStr":"{\"title\":\"A Relapsing Acute Tubulointerstitial Nephritis as an Expression of a Kappa Light Chain Multiple Myeloma: A Case Report.\",\"authors\":\"Andrea Angioi, Nicola Lepori, Matteo Floris, Wisit Cheungpasitporn, Paola Bianco, Gianfranca Cabiddu, Antonello Pani\",\"doi\":\"10.1159/000544930\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Light chain-mediated acute tubulointerstitial nephritis (LCTIN) is a rare and underrecognized renal manifestation of plasma cell dyscrasias, including multiple myeloma. It presents as a dense interstitial inflammatory infiltrate involving polyclonal lymphocytes and plasma cells, often mimicking other forms of tubulointerstitial nephritis and delaying the correct diagnosis.</p><p><strong>Case presentation: </strong>A 46-year-old man was initially managed as having drug-induced acute interstitial nephritis due to NSAID use, responding only transiently to steroids. Upon relapse with worsening kidney function, hypercalcemia, and systemic symptoms, a second kidney biopsy demonstrated again an intense tubulointerstitial infiltrate and κ-light chain proximal tubulopathy.</p><p><strong>Conclusion: </strong>This case illustrates that LCTIN can mimic relapsing interstitial nephritis. Early recognition and appropriate plasma cell-targeted therapy may significantly improve renal outcomes and guide clinical management.</p>\",\"PeriodicalId\":9599,\"journal\":{\"name\":\"Case Reports in Nephrology and Dialysis\",\"volume\":\"15 1\",\"pages\":\"170-176\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-06-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342701/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Case Reports in Nephrology and Dialysis\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1159/000544930\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Nephrology and Dialysis","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000544930","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
A Relapsing Acute Tubulointerstitial Nephritis as an Expression of a Kappa Light Chain Multiple Myeloma: A Case Report.
Introduction: Light chain-mediated acute tubulointerstitial nephritis (LCTIN) is a rare and underrecognized renal manifestation of plasma cell dyscrasias, including multiple myeloma. It presents as a dense interstitial inflammatory infiltrate involving polyclonal lymphocytes and plasma cells, often mimicking other forms of tubulointerstitial nephritis and delaying the correct diagnosis.
Case presentation: A 46-year-old man was initially managed as having drug-induced acute interstitial nephritis due to NSAID use, responding only transiently to steroids. Upon relapse with worsening kidney function, hypercalcemia, and systemic symptoms, a second kidney biopsy demonstrated again an intense tubulointerstitial infiltrate and κ-light chain proximal tubulopathy.
Conclusion: This case illustrates that LCTIN can mimic relapsing interstitial nephritis. Early recognition and appropriate plasma cell-targeted therapy may significantly improve renal outcomes and guide clinical management.
期刊介绍：
This peer-reviewed online-only journal publishes original case reports covering the entire spectrum of nephrology and dialysis, including genetic susceptibility, clinical presentation, diagnosis, treatment or prevention, toxicities of therapy, critical care, supportive care, quality-of-life and survival issues. The journal will also accept case reports dealing with the use of novel technologies, both in the arena of diagnosis and treatment. Supplementary material is welcomed.
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