Solitary plasmacytoma of bone is defined by the presence of a single plasmacytoma in the absence of multiple osteolytic lesions or other findings compatible with multiple myeloma. We report an older patient with solitary plasmacytoma of the sternum associated with atypical clinical findings which complicated diagnosis and possible progression to multiple myeloma. During admission, the patient developed refractory hyponatremia, superficial thrombophlebitis in the left upper limb, periorbital cellulitis, endophthalmitis, and sternal osteomyelitis. Serum protein electrophoresis showed a polyclonal increase in gamma globulins. Biopsy result was compatible with plasmacytoma.
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October Pages Light chain deposition disease. Experience in our environment. Experiencia en nuestro medio.. Download PDF. This item has received. Article information. Se trataron 3 pacientes, 2 con mieloma. Fallecieron 4 pacientes, 2 con mieloma. El tiempo de seguimiento hasta el exitus fue de 13 semanas para los pacientes con mieloma y de semanas para el resto.
Palabras clave:. Glomeruloesclerosis nodular. The Light chain deposition disease LCDD is a strange entity characterised by the deposition of only one type of light chain in the renal tubular basement membranes. It can be associated to a plasma cell dyscrasia, however, it can occur in the absence of any detectable hematological disorder and it is called idiopathic LCDD.
The clinical manifestation is renal insufficiency and nephrotic proteinuria, it does not have a clearly fixed treatment and has a severe prognosis. The aim of this work is to analyse the characteristics of the LCDD cases diagnosed within our environment. Six cases were identified, all of them between and , from a total amount of renal biopsies performed during this period, 4 women and 2 men, average age of All the biopsies showed tubular basement membranes thickening and kappa chains with a linear distribution within the same.
In one of the cases the affectation was exclusively tubular interstitial with tubular casts. The monitoring time until the death was 13 weeks for the patients with myeloma and weeks for the rest. Conclusion: The LCDD seems to be more frequent than what has been published and it is associated to the myeloma in half of the cases. Monoclonal gammopathies. Plasma cell dyscrasia. Nodular sclerosing glomerulopathy.
Light chain nephropathy. The aim of this study was to review our experience with this uncommon disease. Clinical and pathological data and patient course were studied based on clinical records and on the information provided by physicians with whom the patient was in direct contact at the time of study closure. This procedure has been routinely performed at our hospital since Patients with clinical data suggesting involvement of other organs were considered to have extrarenal involvement due to light chain deposition.
Blood electrophoresis detected no monoclonal peaks in any case. Hypogammaglobulinemia was found in 5 patients In a patient, light chain study in urine showed a selective elevation of the kappa light chain suggesting a monoclonal peak this patient was subsequently diagnosed of myeloma. Bone marrow was studied in 5 patients. LCDD was the first sign of the disease in all 3 patients with myeloma. No evidence of myeloma or other plasma cell dyscrasia was found in 3 patients.
Table I shows the characteristics of renal biopsies. Mean time from diagnosis to start of dialysis was 46 days range, In patients diagnosed of myeloma and idiopathic LCDD, times to start of dialysis were 96 days range, and 7 days range, respectively. The third patient diagnosed of myeloma died 15 days after admission from an infectious complication and did not receive chemotherapy.
She died at two years of follow-up. Mean follow-up time was 15 months in myeloma patients 15 days months and 38 months months in idiopathic LCDD. Of the 4 patients who died Renal biopsy therefore plays an essential role in diagnosis of LCDD and its associated dysproteinemia, as evidenced by this and other studies. Renal biopsy is required for diagnosis. Bone marrow study is not always diagnostic, and routine staining with anti-kappa and anti-lambda sera would therefore be required to prevent the disease from being undiagnosed.
This happened with one of our patients, who underwent two bone marrow aspirations with a one month interval. Two of our myeloma patients received VAD cycles, and renal function improvement was achieved in one of them.
Mortality was high in our patients. Wider studies would be required to confirm these results. Renal and patient survival was poor. Subscribe to our newsletter. See more. Print Send to a friend Export reference Mendeley Statistics. Recommended articles. Three cases of monoclonal gammopathy of renal significance This work is licensed under a Creative Commons Attribution 4.
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Publicar un comentario. Pacientes Ampliar. Profesionales de salud. Casos nuevos: Defunciones: Estos estudios iniciales se deben comparar posteriormente con valores subsiguientes, cuando sea necesario decidir si la enfermedad permanece estable o evoluciona, responde al tratamiento o empeora. El paciente tiene un plasmocitoma solitario de hueso si se encuentran los siguientes elementos:.
2011, Número 2
International Myeloma Working Group. Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. Br J Haematol ; International staging system for multiple myeloma.