Multiple miyeloma sekonder MPGN nedeniyle son dönem kronik böbrek yetmezliği gelişen bir olgu sunumu
Abstract
Membranoproliferatif
glomerulonefrit (MPGN) immün komplekslerin subendotelyal ve mezanjial birikimi
ile karakterize bir immün kompleks aracılı glomerulonefrittir.
Membranoproliferatif glomerulonefrit 'in daha az bilinen nedenleri arasında
monoklonal gamopatiler yer almaktadır. Bu yazıda multiple myeloma sekonder
membranoproliferatif glomerülonefrit (MPGN) zemininde son dönem böbrek
yetmezliği gelişen bir olgu sunulmuştur. Olgumuz
51 yaşında ve erkekti. 1 aydır devam eden hipertansiyon, baş ağrısı, ayaklarda
şişlik ve halsizlik şikayetleri ile kliniğimize başvurdu. Hastanın bilinen bir
ek hastalığı ve düzenli tansiyon takibi yoktu. Tetkiklerinde böbrek boyutları
normal olan, dikkat çekici hematürisi
mevcut olan hastada kronik böbrek yetmezliği etyolojisinin aydınlatılması için
böbrek biyopsisi yapıldı ve membranoproliferatif glomerülonefrit (MPGN) tanısı
konuldu. Olgu klinik izlemi sırasında monoklonal
gammopati açısından araştırıldı. Gönderilen idrar immünfiksasyon elektroforezde
serbest kappa hafif zincir proteini saptandı. Kemik iliği aspirasyonu ve
biyopsisi yapıldı, multipl miyelom tanısı konuldu. Nedeni
bilinmeyen kronik böbrek yetmezlikli hastalarda altta yatan sebepleri
aydınlatmaya yönelik böbrek biyopsisi ve ileri incelemeler yapılmalı ve
histopatolojik olarak membranoproliferatif glomerülonefrit tanısı konulduğunda
monoklonal gammopatilerin de arasında olduğu ikincil nedenler mutlaka araştırılmalıdır.
References
- AYAR Y, ERSOY A, YILDIZ A Multipl Myeloma Kidney , Turkish Nephrology, Dialysis and Transplantation Journal , April 2015
- Sethi S , Zand L, Leung N et al. Membranoproliferative Glomerulonephritis Secondary to Monoclonal Gammopathy CJASN February 2010
- Andersen CA , Marcussen N, and Gregersen JW Recovery of renal function succeeding stem cell transplant: a case of C3 Glomerulonephiritis secondary to monoclonal gammopathy Clinical Kidney Journal, Volume 6, Issue 6, 1 December 2013, Pages 639–642
- PAYDAŞ S, KAYA B , PAYDAŞ S, GÖNLÜŞEN G, BALAL M Nephrotic syndrome preceding multiple myeloma Departments of Nephrology, Oncology, Pathology, Çukurova University Faculty of Medicine Turkiye Klinikleri J Med Sci 2013;33(2):591-5
- Leung N, Nasr SH. Myeloma-related kidney disease. ACKD January 2014Volume 21, Issue 1, Pages 36–47
A case report of a patient with end stage chronic renal failure due to MPGN secondary to multiple myeloma
Abstract
Membranoproliferative
glomerulonephritis is an immune complex characterised by deposite of
subendothelial and mesangial. Monoclonal gammopathies are among the few known
reasons for membranoproliferative glomerulonephritis. In this case, multiple
myeloma is presented as secondary cause of membranoproliferative
glomerulonephritis leading to end stage renal failure. Our patient is 50
year-old man presenting with hypertension, headache, weakness and pretibial
edema for one month. The patient has no known addditional disease and no hypertension
follow up. To explain the cause of end stage renal failure in the patient with
normal renal sizes and marked hematuria, renal biopsy was made and membranoproliferative
glomerulonephritis was diagnosed. During
the follow up, monoclonal gammopathy was researched. In the urine immunofixation electrophoresis analysis, free kappa light
chain protein was found and multiple myeloma was diagnosed by bone marrow aspiration
biopsy. To explain the underlying etiology in patients with unknown origin of chronic
renal failure, renal biopsy and further examinations should be performed and
when membranoproliferative glomerulonephritis is diagnosed histopathologically,
monoclonal gammopathies have to be consiedered as a secondary cause.
References
- AYAR Y, ERSOY A, YILDIZ A Multipl Myeloma Kidney , Turkish Nephrology, Dialysis and Transplantation Journal , April 2015
- Sethi S , Zand L, Leung N et al. Membranoproliferative Glomerulonephritis Secondary to Monoclonal Gammopathy CJASN February 2010
- Andersen CA , Marcussen N, and Gregersen JW Recovery of renal function succeeding stem cell transplant: a case of C3 Glomerulonephiritis secondary to monoclonal gammopathy Clinical Kidney Journal, Volume 6, Issue 6, 1 December 2013, Pages 639–642
- PAYDAŞ S, KAYA B , PAYDAŞ S, GÖNLÜŞEN G, BALAL M Nephrotic syndrome preceding multiple myeloma Departments of Nephrology, Oncology, Pathology, Çukurova University Faculty of Medicine Turkiye Klinikleri J Med Sci 2013;33(2):591-5
- Leung N, Nasr SH. Myeloma-related kidney disease. ACKD January 2014Volume 21, Issue 1, Pages 36–47
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Urology |
| Journal Section | Case Report |
| Authors | |
| Publication Date | May 14, 2020 |
| Submission Date | July 18, 2019 |
| Acceptance Date | March 16, 2020 |
| Published in Issue | Year 2020 Volume: 13 Issue: 2 |
