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KMID : 0882420150880030318
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Korean Journal of Medicine
2015 Volume.88 No. 3 p.318 ~ p.323
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A Case of Light Chain Deposition Disease in a Patient with Diabetes and Nodular Glomerulosclerosis
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Lee Kyung-Ho
Kang Soo-Hoon
Lee Hyun-Woo
Park Ga-Eun
Hong Yun-Soo
Lee Jung-Eun
Kim Yoon-Goo
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Abstract
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A 50 year-old male with a 10-year history of diabetes was admitted to the hospital for edema and foamy urine. At the time of admission, serum creatinine was 1.99 mg/dL and 24 h urine protein levels were 4.0 g/day. Renal biopsy showed nodular glomerulosclerosis. Immunofluorescence demonstrated the presence of kappa light chains along the glomerular and tubular basement membrane. Electron microscopy showed granular electron-dense deposits along the glomerular subendothelium and tubular basement membrane. Serum protein electrophoresis was negative for a monoclonal spike; however, urine protein electrophoresis demonstrated a monoclonal spike. Bone marrow examination was compatible with multiple myeloma and the patient was diagnosed with light-chain deposition disease associated with multiple myeloma. This report stresses the significant challenges that occur when diagnosing light-chain deposition disease in kidneys of patients with long standing diabetes, and discusses previously reported cases of light-chain deposition disease in Korea.
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KEYWORD
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Immunoglobulin light chains, Diabetic nephropathies, Multiple myeloma
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