Collapsing Glomerulopathy in Lambda Light Chain Amyloidosis: A Report of 2 Cases

Mazdak Khalighi, Alexander J. Gallan, Anthony Chang, Shane M. Meehan

Research output: Contribution to journalArticle

Abstract

Amyloid nephropathy is an uncommon disease that frequently presents with reduced kidney function and proteinuria and, in developed nations, is most often associated with underlying paraproteinemia. The histologic appearance of glomerular amyloid deposition includes mesangial and capillary wall infiltration by an amorphous eosinophilic material, and features of endo- or extracapillary proliferation are not typically seen. Rare cases of crescentic injury have been reported in a subset of patients with amyloid nephropathy, particularly those with amyloid derived from serum amyloid A protein. Collapsing glomerulopathy, which like crescentic injury is associated with an extracapillary proliferation, has not to our knowledge been reported in the setting of amyloid nephropathy. We report 2 patients presenting with acute kidney injury and nephrotic syndrome found to have amyloid nephropathy with prominent epithelial cell hyperplasia and glomerular collapse on biopsy. This injury is likely multifactorial and related to direct podocyte injury and vascular compromise and expands further the spectrum of paraprotein-associated renal injury.

Original languageEnglish (US)
Pages (from-to)612-616
Number of pages5
JournalAmerican Journal of Kidney Diseases
Volume72
Issue number4
DOIs
StatePublished - Oct 1 2018
Externally publishedYes

Keywords

  • acute kidney injury (AKI)
  • AL amyloidosis
  • amyloid nephropathy
  • Amyloidosis
  • case report
  • collapsing glomerulopathy
  • deposition
  • immunoglobulin
  • lambda
  • light chain
  • nephrotic syndrome
  • paraprotein
  • renal biopsy

ASJC Scopus subject areas

  • Nephrology

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