A Concurrence of Light and Heavy Chain Deposition Disease and Diabetic Nephropathy
Bancha Satirapoj MD*, Paisit Paueksakon MD**
Affiliation : * Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine ** Department of Pathology, Phramongkutklao Hospital and College of Medicine
A 56-year-old female patient was clinically characterized by heavy proteinuria, anemia, hypertension, and no detectable monoclonal protein in serum or urine. She had a history of diabetes with retinopathy and hypertension. Histological investigation of renal biopsy specimens revealed nodular glomerulosclerosis. Light microscopic examination did not allow discrimination between diabetic glomerulosclerosis and mono- clonal immunoglobulin deposition disease (MIDD). Immunofluorescent examination showed linear capillary wall and tubular basement membrane staining with kappa, and IgG staining. Electron-microscopic examina- tion confirmed the amorphous material along the glomerular basement. Based on these findings, the diagnosis of light chain and heavy chain monoclonal immunoglobulin deposition disease (LHCDD) and diabetic neph- ropathy was made. At the present after the 7th course of melphalan and prednisolone treatment, her renal function and proteinuria have progressively improved.
Keywords : Light and heavy chain deposition disease (LHCDD), Nodular glomerulosclerosis, Monoclonal protein, Diabetic glomerulosclerosis
