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KMID : 0981820090290050384
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Korean Journal of Laboratory Medicine
2009 Volume.29 No. 5 p.384 ~ p.389
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A Case of Light Chain Deposition Disease Involving Kidney and Bone Marrow with Microangiopathic Hemolytic Anemia
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Cho Young-Uk
Chi Hyun-Sook
Park Chan-Jeoung
Jang Sung-Su
Cho Yong-Mee
Park Jung-Sik
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Abstract
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We report a case of light chain deposition disease in a 59-yr-old female showing deposition of monoclonal light chain in the kidney and bone marrow accompanied with a schistocytosis, the morphologic finding of microangiopathic hemolytic anemia. The immunofluorescence examination of the kidney revealed strongly stained κ-light chain deposits on the glomerular mesangium and capillary wall, tubules, and vessel wall. The electron microscopy demonstrated electron-dense deposits on the glomerular basement membrane and mesangium. Anemia was observed with schistocytosis and Howell-Jolly body in the peripheral blood smears. The immunohistochemical examination of the bone marrow showed the presence of κ-light chain deposits in scattered plasma cells and thickened vessel wall in the absence of a prominent plasma cell proliferation. Although an immunofixation electrophoresis failed to detect a monoclonal gammopathy, the presence of monoclonal protein could be identified by an abnormal κ/λratio on the serum free light chain analysis.
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KEYWORD
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Light chain deposition disease, Kidney, Bone marrow, Microangiopathic hemolytic anemia
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