Sex/age | Duration of onset to presentation | Clinical renal manifestation | Plasma cell dyscrasia | Glomerular pathology | Crystal distribution | IHC | Treatment | Prognosis |
---|---|---|---|---|---|---|---|---|
M/29 [12] | 12 months | Recurrent proteinuria after two kidney allografts, PCR 6 g/g, SCr 2.3 mg/dl | MGUS→IgG-κ MM | Recurrent FSGS | Podocytes, proximal TEC | IF/IHC:Positive for κ in TEC, λ negative | Bortezomib, lenalidomide, dexamethasone | Lacking |
F/66 [11] | During evaluation for back pain | SCr 1.7 mg/dl, Fanconi syndrome, albumin 29 g/L, PCR 3.11μg/mgCr | IgG-κ MM | Non-specific | Podocytes, MC, GEC, TEC, tubular lumen,histiocytes | IF:Positive for κ; negative for λ | Bortezomib, melphalan, prednisolone | Overall improvement in her myeloma related laboratory results |
F/52 [10] | Routine health examination | Proteinuria 2.62 g/d, SCr 1.3 mg/dl | IgG-κ MM | FSGS | Podocytes, proximal TEC | IHC: κ positive in TEC, λ negative | Lacking | Lacking |
M/45 [9] | Routine annual physical examination | SCr 1.85 mg/dl, proteinuria 7.925 g/d, glycosuria | IgG-κ MM | Collapsing FSGS | Podocytes,MC, TEC | IF/IHC: negative for κ and λ in crystal areas | Therapy, details lacking | 2 m later, SCr 1.5 mg/dl, proteinuria 3.627 g/d |
M/53 [15] | 78 months of MGUS | SCr 1.3 mg/dl, proteinuria 1.18 g/d, albumin 38 g/L | IgG-κ MGUS | Foamy substance in podocytes | Podocytes and TEC | IF: κ TEC positive; λ negative | 4 cycles of DF and lenalidomide | SCr returned to 1.0 mg/dl |
F/54 [13] | 24 months of MM, 19 months of proteinuria | SCr1.0 → 3.9 mg/dl(2 yrs), proteinuria0.3 → 14.4 g/d (2 yrs., pamidronate), albumin 29 g/L | IgG-κ MM | Collapsing FSGS and LCN | Proximal TECs, podocytes,tubular casts | IF: Negative for κ and λ;IHC: Positive for κ, negative for λ | DF, CYC, thalidomide, bortezomib, HCT | SCr 1.8 mg/dl |
M/56 [8] | < 1 month | SCr1.2 → 9.2 mg/dl (3 m), proteinuria 5 g/L | IgG-κ MM | NA, ATN | Podocytes, TEC, interstitial macrophages, tubular lumen,BM, urine | IF: Negative for both κ and λ | Vincristine, doxorubicin, DF, HCT | SCr 6.3 mg/dl |
F/46 [7] | Unknown | Renal dysfunction | IgG-κ MM | NA | Podocytes, TECs, Interstitial histiocytes | IF: Positive for IgG-κ | Chemotherapy followed by HCT | SCr↓, crystalline- containing podocyte ↓ |
M/51 [6] | 6 months | Bence–Jones proteinuria 1.54 g/L, albumin 41.8 g/L | IgG-κ MM | Nonspecific | Podocytes, GEC, MC, TEC, Interstitial histiocytes,, MCs, hepatocytes and macrophages in liver | NA | Chemotherapy deferred due to lung carcinoma surgery | Died shortly after lung surgery due to multi- organ failure |
F/52 [5] | 60 months | SCr 1.8 → 2.0 mg/dl (5 yrs), Proteinuria 1.3 → 5 g/d(5 yrs), albumin 34 g/L | IgG-κ MM | 3/5 G sclerosed | Podocytes, PEC, TEC, interstitial histiocytes | IF: Negative for κ and λ;IHC: Positive for κ, negative for λ | NA | NA |
F/40 [14] | 14 months | Proteinuria 14.3 g/d, albumin 30 g/L, SCr 1.8 mg/dl | IgG-κ MGUS | FSGS | Podocytes, PEC, distal TECs, tubular lumina, BM | IHC: Positive for κ, negative for λ | NA | NA |
M/75 [4] | 60 months of MM | Proteinuria;chronic renal failure | IgG-κ MM | NA | Podocytes, PEC, TEC, interstitial histiocytes, cornea, myeloma cell, choroid plexus | IHC: Positive for κ and γ | NA | NA |
M/57 [3] | 6 months | SCr 3.2 mg/dl, Proteinuria 2 g/d | IgG-κ MM | FSGS | Podocytes, MC, GEC, PEC, proximal TEC, histiocytes and fibroblasts in the interstitium, synovium and BM | IF: Negative | Cytoxan, carmustine and prednisone, discontinued due to complications | 1.5 years later SCr 3.9 mg/dl, died due to cardiac arrest |