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Revista Colombiana de Nefrología
On-line version ISSN 2500-5006
Abstract
NAKAMURA, Kenyi Kuratomi; MEJIA, Andrés Felipe; VALDERRAMA COMETA, Luis Alfonso and CASANOVA VALDERRAMA, María Eugenia. Atypical renal involvement in light chain amyloidosis: case report. Rev. colom. nefrol. [online]. 2022, vol.9, n.2, 403. Epub Aug 01, 2022. ISSN 2500-5006. https://doi.org/10.22265/acnef.9.2.559.
Introduction
Light chain amyloidosis is an entity triggered by the proliferation of a clone of plasma cells that generates the accumulation of light chains, which are deposited in the form of amyloid fibrils generating organic dysfunction. Renal compromise generally manifests as nephrotic syndrome, with a slow and progressive decline of renal function that can lead to dialysis therapy.
Purpose
The objective of this case report is to demonstrate the aggressive and subacute renal involvement of systemic amyloidosis.
Case presentation
We present a case of a 35-year-old male patient who consulted for general malaise, blurred vision, dizziness and oliguria with elevated nitrogen levels that progressed fastly to the requirement of hemodialysis in approximately 3 months. It was also reveal peripheral polyneuropathy, cardiac infiltration, and slight elevation of transaminases. Given the negativity of extension studies, amyloid deposits were documented histopathologically with positive immunofluorescence for LA. He is currently receiving chemotherapy regimen with adequate clinical stability and tolerance.
Conclusion and discussion
To conclude, AL amyloidosis is a rare entity, with significant multi-organ involvement and high rates of morbidity and mortality. In this case, the subacute involvement with an early requirement for dialysis therapy is emphasized, and the importance of suspicion and timely diagnosis in patients with kidney involvement and other systemic manifestations is emphasized.
Keywords : light chain amyloidosis; immunofluorescence; kidney disease; dialysis therapy..