Light chain nephropathy

Raymond R. Tubbs, Gordon N. Gephardt, James T. McMahon, Phillip M. Hall, Rafael Valenzuela, Donald G. Vidt

Research output: Contribution to journalArticle

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Abstract

In 13 specimens of renal tissue from 11 patients, deposits of monoclonal immunoglobulin light chains and continuous granular electron-dense material within tubular basement membranes and in association with the glomerular basement membrane were identified. All but one patient were men in the fifth to seventh decades of life, and each presented with azotemia and features of glomerular rather than tubulointerstitial disease. Osteolytic bone lesions occurred in only three patients, and a bone marrow plasmacytosis >30 percent consistent with plasma cell myeloma was identified in only four patients. Light chain distribution in the nephron was confirmed with immunoelectron microscopy and was not associated with deposition of other serum proteins such as immunoglobulin heavy chains, complement, transferrin, alpha2 macroglobulin and albumin. The electron dense deposits differed in distribution and character from those associated with membranoproliferative glomerulonephritis type II (dense deposit disease), amyloidosis, cryoglobulinemla, macroglobulinemia and benign monoclonal gammopathy. Serum from six of these patients did not bind to normal human or rat renal parenchyma in vitro. Kappa light chain nephropathy was characterized by predominant linear tubular basement membrane κ deposits, and nodular mesangial and linear glomerular basement membrane κ immunostaining. Lambda light chain nephropathy was characterized by linear λ glomerular basement membrane and tubular basement membrane immunostaining. Manifestations of glomerular dysfunction dominated the clinical presentation of light chain nephropathy, and most patients did not have typical features of multiple myeloma. The diagnosis was predicated upon thorough immunohistologic assessment of renal biopsy material.

Original languageEnglish
Pages (from-to)263-269
Number of pages7
JournalThe American Journal of Medicine
Volume71
Issue number2
DOIs
StatePublished - Jan 1 1981

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Light
Glomerular Basement Membrane
Basement Membrane
Membranoproliferative Glomerulonephritis
Multiple Myeloma
Kidney
Electrons
Monoclonal Gammopathy of Undetermined Significance
Azotemia
alpha-Macroglobulins
Immunoglobulin Light Chains
Waldenstrom Macroglobulinemia
Immunoglobulin Heavy Chains
Immunoelectron Microscopy
Nephrons
Amyloidosis
Transferrin
Blood Proteins
Albumins
Bone Marrow

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Tubbs, R. R., Gephardt, G. N., McMahon, J. T., Hall, P. M., Valenzuela, R., & Vidt, D. G. (1981). Light chain nephropathy. The American Journal of Medicine, 71(2), 263-269. https://doi.org/10.1016/0002-9343(81)90127-3

Light chain nephropathy. / Tubbs, Raymond R.; Gephardt, Gordon N.; McMahon, James T.; Hall, Phillip M.; Valenzuela, Rafael; Vidt, Donald G.

In: The American Journal of Medicine, Vol. 71, No. 2, 01.01.1981, p. 263-269.

Research output: Contribution to journalArticle

Tubbs, RR, Gephardt, GN, McMahon, JT, Hall, PM, Valenzuela, R & Vidt, DG 1981, 'Light chain nephropathy', The American Journal of Medicine, vol. 71, no. 2, pp. 263-269. https://doi.org/10.1016/0002-9343(81)90127-3
Tubbs RR, Gephardt GN, McMahon JT, Hall PM, Valenzuela R, Vidt DG. Light chain nephropathy. The American Journal of Medicine. 1981 Jan 1;71(2):263-269. https://doi.org/10.1016/0002-9343(81)90127-3
Tubbs, Raymond R. ; Gephardt, Gordon N. ; McMahon, James T. ; Hall, Phillip M. ; Valenzuela, Rafael ; Vidt, Donald G. / Light chain nephropathy. In: The American Journal of Medicine. 1981 ; Vol. 71, No. 2. pp. 263-269.
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