Journal Article

Biopsy-proven resolution of renal light-chain deposition disease after autologous stem cell transplantation

Ioannis Petrakis, Kostas Stylianou, Vasiliki Mavroeidi, Eleftheria Vardaki, Spyridon Stratigis, Stavros Stratakis, Irene Xylouri, Constantinos Perakis, Constantina Petraki, Lydia Nakopoulou and Eugene Daphnis

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 25, issue 6, pages 2020-2023
Published in print June 2010 | ISSN: 0931-0509
Published online February 2010 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfq023
Biopsy-proven resolution of renal light-chain deposition disease after autologous stem cell transplantation

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Light-chain deposition disease (LCDD) is caused by an underlying clonal plasma cell dyscrasia in which monoclonal immunoglobulin light chains (LCs) are deposited in tissues, resulting in varying degrees of organ dysfunction. Autologous stem cell transplantation (ASCT) has been reported to stabilize renal function in patients with LCDD, but currently, no evidence of histopathologic resolution of LC deposition after ASCT exists. We present a patient, with severe renal dysfunction due to LCDD, who was treated with high-dose melphalan and ASCT that resulted in a significant and extended period of improved renal function. Four years after the initial improvement, the patient developed nephrotic range proteinuria, without any evidence of relapse of the plasma cell dyscrasia. At that time, a repeat renal biopsy showed complete resolution of LC depositions and development of extensive glomerulosclerosis, thus explaining proteinuria. To the best of our knowledge, this is the first report of a biopsy-proven resolution of renal LCDD following ASCT. A timely application of ASCT should be considered in LCDD to prevent deterioration of renal function in the long run.

Keywords: autologous stem cell transplantation; light-chain deposition disease; renal biopsy

Journal Article.  2482 words.  Illustrated.

Subjects: Nephrology

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