Cast nephropathy: Clinicopathologic analysis of 4 cases

Mathew, Mary and Kishore, Manjari (2015) Cast nephropathy: Clinicopathologic analysis of 4 cases. International Journal of Science and Research (IJSR), 4 (1). pp. 2551-2554. ISSN 2319-7064

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Multiple myeloma is a malignancy of plasma cells. Myeloma Cast Nephropathy (myeloma kidney), refers to intrinsic Acute Kidney Injury (AKI) that results as the filtered light chain component of M-protein (Bence-Jones protein) exerts toxic & obstructive injury to tubules. A total of 4 cases diagnosed with cast nephropathy between Jan’2010-Apr’2014 were analysed retrospectively as per histopathological and clinical criteria. All 4 cases were between age 44-62 yrs, 3 were males & 1 female. 1 case showed light chain cast nephropathy with early features of acute tubulopathy. Second case showed evidence of light chain deposition disease with inflammatory tubulointerstitial nephritis alongwith light chain cast nephropathy. Rest 2 of the cases showed presence of cast nephropathy with superadded hypertension induced changes. Conclusion: Cast nephropathy is seen in 30 to 50% patients of multiple myeloma. The likelihood of underlying cast nephropathy is increased in cases of more profound AKI. Cast nephropathy can be misinterpreted as interstitial nephritis, amyloidosis, light chain deposition diseases, etc., hence vital for nephrologists to review the histology with pathologists to avoid misdiagnosis.

Item Type: Article
Uncontrolled Keywords: Myeloma kidney; acute kidney injury; cast nephropathy; bence jones proteins; tamm horsfall protein.
Subjects: Medicine > KMC Manipal > Pathology
Depositing User: KMC Manipal
Date Deposited: 30 Jun 2015 09:31
Last Modified: 30 Jun 2015 09:31

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