Improvement of Light Chain Proximal Tubulopathy without Crystals in IgGλ-type Monoclonal Gammopathy of Undetermined Significance Using Bortezomib and Dexamethasone
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- Tsuyuki Tomohisa
- Department of Nephrology, Nagasaki University Hospital, Japan
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- Uramatsu Tadashi
- Department of Nephrology, JCHO Isahaya General Hospital, Japan
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- Shimizu Masatoshi
- Department of Nephrology, Nagasaki University Hospital, Japan
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- Ishi Takuma
- Department of Nephrology, Nagasaki University Hospital, Japan
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- Tsuji Kiyokazu
- Department of Nephrology, JCHO Isahaya General Hospital, Japan
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- Nakashima Jun
- Department of Hematology, JCHO Isahaya General Hospital, Japan
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- Katafuchi Eisuke
- Department of Pathology, University of Occupational and Environmental Health School, Japan
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- Nakayama Toshiyuki
- Department of Pathology, University of Occupational and Environmental Health School, Japan
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- Uesugi Noriko
- Department of Pathology, Fukuoka University Hospital, Japan
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- Muta Kumiko
- Department of Nephrology, Nagasaki University Hospital, Japan
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- Nishino Tomoya
- Department of Nephrology, Nagasaki University Hospital, Japan
抄録
<p>A 70-year-old woman with acute kidney injury, a high serum Creatinine (Cr) level (3.91 mg/dL), and proteinuria (protein/Cr ratio 1.59 g/gCr) was admitted. Serum IgG λ-type and urinary λ-type M proteins were observed. A bone marrow examination indicated monoclonal gammopathy of undetermined significance (MGUS). A renal biopsy showed distended proximal tubular cells, and immunofluorescence identified tissue positive for proximal tubular cell λ light chains. Electron microscopy identified fibril-like structures in the lysosomes. The patient was diagnosed with light chain proximal tubulopathy without crystals in IgG λ-type MGUS and treated with bortezomib and dexamethasone therapy, which improved her renal function. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 63 (5), 693-698, 2024-03-01
一般社団法人 日本内科学会