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Related Experiment Videos

Crystalline glomerular inclusions in multiple myeloma.

P H Carstens1, D Woo

  • 1Department of Pathology, University of Louisville, KY 40292.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|July 1, 1989
PubMed
Summary

A rare case of multiple myeloma presented with unusual crystalline inclusions in the kidneys and synovium. These deposits were linked to IgG, kappa myeloma, highlighting a novel form of kidney involvement.

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Area of Science:

  • Nephrology
  • Hematology
  • Pathology

Background:

  • A 57-year-old male presented with edema and hand pain, accompanied by renal dysfunction (elevated creatinine and BUN) and proteinuria.
  • Initial findings suggested a potential novel metabolic disease due to crystalline inclusions in renal glomeruli.

Observation:

  • Crystalline inclusions were identified in various renal cell types, including visceral epithelium, endothelium, mesangial cells, parietal epithelium, and proximal tubule cells.
  • Electron microscopy revealed geometrically shaped crystalline structures without a defined substructure; immunofluorescence was negative.
  • Similar crystalline inclusions were later found in synovial tissue during carpal tunnel surgery.

Findings:

  • The patient was diagnosed with IgG, kappa multiple myeloma with Bence Jones proteinuria.

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  • Crystalline inclusions were also detected within lymphoplasmacytic cells in the bone marrow.

    • Implications:

    • This case represents a rare and previously undescribed manifestation of glomerular involvement in multiple myeloma.
    • The findings suggest a potential link between specific myeloma protein types and the formation of crystalline deposits in renal and extra-renal tissues.