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U06-11469

U06-11469. #426820800 Native (L) kidney Proteinuria. U06-11469 59 year old Caucasian male no significant past medical history; normal u/a Nov 2002 and ?July 2003 (1+ protein on highly concentrated urine)

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U06-11469

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  1. U06-11469 #426820800 • Native (L) kidney • Proteinuria

  2. U06-11469 • 59 year old Caucasian male • no significant past medical history; normal u/a Nov 2002 and ?July 2003 (1+ protein on highly concentrated urine) • presented in December 2005 with new onset of peripheral edema; no renal work-up performed at that time • found to have nephrotic syndrome May 2006; serum albumin 28 g/L • work-up revealed serum creatinine of 88 µM with urine protein/creatinine ratio of 683 – 860 mg/mmol, negative hepatitis serology, no diabetes, normal complements, negative dsDNA, serum PEP=nephrotic syndrome, urine PEP=free lambda light chain • bone marrow Bx did not meet criteria for diagnosis of multiple myeloma • renal Bx results… • remainder of investigations….. • plan…..

  3. IF • No glomeruli are seen

  4. 10 nm mean diameter

  5. DiagnosisRenal Biopsy:Renal amyloidosis in an early stage with relatively small amounts of amyloid deposited and few changes by light microscopy.

  6. U06-11469 • 59 year old Caucasian male • no significant past medical history; normal u/a Nov 2002 and ?July 2003 (1+ protein on highly concentrated urine) • presented in December 2005 with new onset of peripheral edema; no renal work-up performed at that time • found to have nephrotic syndrome May 2006; serum albumin 28 g/L • work-up revealed serum creatinine of 88 µM with urine protein/creatinine ratio of 683 – 860 mg/mmol, negative hepatitis serology, no diabetes, normal complements, negative dsDNA, serum PEP=nephrotic syndrome, urine PEP=free lambda light chain • bone marrow Bx did not meet criteria for diagnosis of multiple myeloma • renal Bx revealed amyloidosis • remainder of investigations revealed cardiac amyloid with spickling and thickening of myocardium…..; normal function • plan autologous stem cell transplant mid-September

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