Light chain deposition disease after renal transplantation: a report of 2 cases and a review of literature / 中华器官移植杂志

ABSTRACT

Objective:To report for the first time the clinicopathologic characteristics of two patients with light chain deposition disease after renal transplantation.Methods:The clinicopathologic features were analyzed for two patients with light chain deposition disease and the related literature was reviewed.Case 1 was a 49-year-old male with unknown primary disease presenting with abnormal urine test and elevated serum creatinine at 24 months after kidney transplantation. Renal allograft biopsy hinted at light chain deposition disease. Case 2 was a 38-year-old male with light chain deposition disease in native kidneys presenting with proteinuria, microscopic hematuria and elevated serum creatinine at 15 months after kidney transplantation. Renal allograft biopsy supported recurrent light chain deposition disease.Results:1 case after bortezomib and dexamethasone dosing, serum creatinine decreased during follow-ups. 1 case received bortezomib and dexamethasone. However, sepsis and pulmonary infections developed and allograft function deteriorated.Conclusions:Light chain deposition disease after renal transplantation is a rare disorder with a rapid progression and a poor prognosis. Early detection of free light chain in blood and urine through immune fixed electrophoresis is conducive to an early diagnosis. The efficacy of bortezomib is to be furthered examined.