C3 glomerulonephritis in multiple myeloma: A case report and literature review
Guang Yin1, Zhen Cheng, Cai-Hong Zeng
1National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
Insights
C3 glomerulonephritis (C3 GN), a kidney disease from complement system activation, is linked to multiple myeloma (MM). This case study suggests C3 GN may be a new kidney complication in MM patients.
Area of Science:
- Nephrology
- Complement System Biology
- Hematology
Background:
- C3 glomerulonephritis (C3 GN) is characterized by C3 deposition in the kidneys due to alternative complement pathway dysregulation.
- While linked to systemic diseases, its association with multiple myeloma (MM) is not well-established.
Observation:
- A 64-year-old female presented with hematuria, renal dysfunction, anemia, and weight loss.
- Diagnosis of IgG-λ multiple myeloma was confirmed via serum immunofixation and bone marrow biopsy.
- Renal biopsy revealed histological features of C3 GN, including mesangial/endocapillary proliferation and C3 deposition.
Findings:
- Histopathology confirmed C3 GN with characteristic glomerular C3 deposition and low serum C3 levels.
- The findings suggest C3 GN occurring in the context of multiple myeloma.
- This case provides evidence for a link between C3 GN and MM.
Implications:
- C3 GN may represent a novel nephropathy associated with multiple myeloma.
- Further research is needed to elucidate the underlying mechanisms of this association.
- This highlights the importance of renal evaluation in MM patients presenting with kidney abnormalities.
Background:
C3 glomerulonephritis (C3 GN) is a recently defined entity characterized by predominant C3 deposition in glomeruli due to abnormal activation of the alternative pathway of complement system. C3 GN has been reported to be associated with several systemic diseases. However, the association between C3 GN and multiple myeloma (MM) has not been well established.
Methods:
We herein describe a case presenting with C3 GN on top of MM.
Results:
A 64-year-old Chinese female presented with gross hematuria, renal dysfunction, anemia, and weight loss. Results of serum immunofixation assay and bone marrow biopsy confirmed the diagnosis of IgG-λ-type MM. In addition, renal biopsy demonstrated histological findings characteristic of C3 GN, including mesangial and endocapillary proliferation under light microscope, electron-dense deposits under electron microscope, and diffuse granular deposition of C3 with no immunoglobulin under immunofluorescence microscope. These histological findings, combined with low serum C3 level, suggested the occurrence of C3 GN in the context of MM.
Conclusion:
This case study provides additional evidence to the literature in terms of the association between C3 GN and MM. We hypothesize that C3 GN may present as a new variant of nephropathy in MM and the mechanism behind this association merits further study.
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