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Multiple Myeloma as a Potential Cause of Low Complements in Patients With Acute Kidney Injury
Kimberly Q Nguyen1, Alexander Ting1, Lorraine I Chong Tai1
1Internal Medicine, Broward Health Medical Center, Fort Lauderdale, USA.
Abstract:
Multiple myeloma (MM) is a plasma cell malignancy belonging to the class of monoclonal gammopathies that leads to end-organ damage myeloma events that encompass anemia, the presence of lytic bone lesions, hypercalcemia, and renal insufficiency. However, there are very few reported cases of patients with low complements in the context of MM and renal failure. Traditionally, low complements in glomerular disease are associated with conditions such as membranoproliferative glomerulonephritis, cryoglobulinemia, systemic lupus erythematous, and post-infectious glomerulonephritis. Despite its rarity, physicians should maintain a high degree of suspicion and consider MM as a potential cause of low complements in patients with renal injury. In this case report, we present a patient with a history of MM associated with acute kidney injury with hypocomplementemia, an atypical presentation of myeloma in MM.
Insights
Multiple myeloma (MM), a plasma cell cancer, can present with low complement levels and acute kidney injury. This rare presentation highlights the need to consider MM in patients with renal failure and hypocomplementemia.
Area of Science:
- Nephrology
- Hematology
- Immunology
Background:
- Multiple myeloma (MM) is a plasma cell malignancy causing end-organ damage, including renal insufficiency.
- Low complement levels are typically linked to other glomerular diseases, not commonly MM.
- Few cases report hypocomplementemia in patients with MM and renal failure.
Observation:
- This case report details a patient with a history of MM experiencing acute kidney injury (AKI).
- The patient presented with hypocomplementemia, an unusual finding in the context of MM.
- This presentation challenges traditional associations of low complements with specific glomerular diseases.
Findings:
- The patient's presentation of AKI with hypocomplementemia was atypical for MM.
- This case underscores the importance of considering MM in the differential diagnosis of renal injury with low complements.
- The co-occurrence of MM, AKI, and hypocomplementemia is exceptionally rare.
Implications:
- Physicians should maintain a high index of suspicion for MM in patients with unexplained renal injury and low complement levels.
- This case expands the known spectrum of MM presentations.
- Further research may elucidate the mechanisms linking MM, renal damage, and complement dysregulation.
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