医学
单克隆
肾小球肾炎
肾
美罗华
血浆置换术
肾功能
病理
单克隆抗体
不确定意义的单克隆抗体病
克隆(Java方法)
肾脏疾病
免疫学
内科学
抗体
生物
DNA
淋巴瘤
遗传学
作者
Abdurrahman Hamadah,Mira T. Keddis,Lynn D. Cornell,Nelson Leung
标识
DOI:10.1053/j.ajkd.2014.08.015
摘要
A growing number of monoclonal gammopathy-associated kidney diseases recently have been recognized. We present the case of a 54-year-old man who presented with acute kidney injury and hypocomplementemia. Kidney biopsy confirmed the presence of immunoglobulin G κ pseudothrombi with intracytoplasmic crystals in glomeruli and tubules. Levels of κ free light chains were elevated without a detectable monoclonal gammopathy, and bone marrow biopsy results were normal. After the first course of rituximab, cyclophosphamide, and dexamethasone in addition to daily plasmapheresis, kidney function recovered within 2 weeks and dialysis therapy was discontinued. Treatment for monoclonal protein-induced kidney disease should be considered in the setting of progressive decreased kidney function, even in the absence of a circulating monoclonal protein or cellular clone of origin.
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