Diagnosis of light chain cast nephropathy through immunostaining of the urine: Perfecting the "liquid biopsy"

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dc.contributor.authorPablo Huidobro, Juan E.
dc.contributor.authorAnghileri, Fiorella
dc.contributor.authorMendez, Gonzalo P.
dc.contributor.authorBarrera, Gonzalo
dc.contributor.authorReyes, Romina
dc.contributor.authorSepulveda, Rodrigo A.
dc.date.accessioned2025-01-20T22:08:32Z
dc.date.available2025-01-20T22:08:32Z
dc.date.issued2021
dc.description.abstractLight chain (LC) cast nephropathy is the main cause of kidney injury and an important determinant of poor survival in patients with multiple myeloma (MM). It is usually suspected when an MM patient with elevated serum concentration of free LC presents kidney failure, but it often requires confirmation by kidney biopsy. We report the case of a 73-year-old woman who presented with fatigue, weight loss, and constipation. Laboratory exams revealed anemia, hypercalcemia, and kidney failure. Urine sediment analysis demonstrated irregular crystalline "waxy type" casts. With the hypothesis of LC cast nephropathy, immunostaining of the urine sediment was performed. The analysis revealed several rectangular and irregular casts with intense and bright stain for lambda LCs only. A myelogram was performed, showing extensive occupation of the bone marrow by plasma cells; and immunofixation in urine and serum revealed monoclonal IgG-lambda component, confirming the diagnosis of IgG-lambda MM. This case highlights the potential utility of the urine sediment analysis and immunostaining as a reliable non-invasive alternative method for diagnosis of cast nephropathy in patients with monoclonal gammopathies.
dc.fuente.origenWOS
dc.identifier.doi10.5414/CN110395
dc.identifier.issn0301-0430
dc.identifier.urihttps://doi.org/10.5414/CN110395
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/94299
dc.identifier.wosidWOS:000695649100007
dc.issue.numero4
dc.language.isoen
dc.pagina.final242
dc.pagina.inicio239
dc.revistaClinical nephrology
dc.rightsacceso restringido
dc.subjectlight chain cast nephropathy
dc.subjectimmunoglobulin light chains
dc.subjectmultiple myeloma
dc.subjectacute kidney injury
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleDiagnosis of light chain cast nephropathy through immunostaining of the urine: Perfecting the "liquid biopsy"
dc.typeartículo
dc.volumen96
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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