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)

• 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…..

IF

• No glomeruli are seen

10 nm mean diameter

Diagnosis

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

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