%0 Journal Article
%T Trombose de veia renal, doen a de dep車sito de cadeias leves e nefropatia dos cilindros em paciente com mieloma m迆ltiplo Renal vein thrombosis, light-chain deposition disease and cast nephropathy in a multiple myeloma patient
%A Vilma Takayasu
%A Silvana Maria Lovisolo
%A Leonardo de Abreu Testagrossa
%A Alo赤sio Felipe-Silva
%J Autopsy and Case Reports
%D 2012
%I University of S?o Paulo
%X Mulher de 56 anos, hipertensa h芍 16 anos em tratamento, apresenta quadro de dor tor芍cica e dispn谷ia h芍 3 dias. A investiga  o laboratorial demonstrou insufici那ncia renal aguda com indica  o de hemodi芍lise. Ap車s di芍lise, apesar de melhora cl赤nico-laboratorial, apresentou fibrila  o ventricular e parada cardiorrespirat車ria revertidas. Evoluiu olig迆rica, sem d谷ficits neurol車gicos. Foi iniciada investiga  o laboratorial para mieloma m迆ltiplo que demonstrou hipogamaglobulinemia sem pico monoclonal na eletroforese de prote赤nas. Durante a investiga  o a paciente apresentou novo epis車dio de fibrila  o ventricular e 車bito. A aut車psia demonstrou trombose de veia renal esquerda, mieloma m迆ltiplo plasmac赤tico com acometimento de medula 車ssea, nefropatia por dep車sito difuso de cadeias leves kappa glomerular e tubular e nefropatia dos cilindros do mieloma. Este caso ilustra uma associa  o incomum entre nefropatia dos cilindros, nefropatia por dep車sito de cadeias leves e trombose de veia renal em paciente com mieloma m迆ltiplo e insufici那ncia renal aguda. A 56-year-old woman presented with thoracic pain and dyspnea for 3 days. She had been under treatment for systemic arterial hypertension for 16 years. Laboratory investigation showed acute renal failure with indication for hemodialysis. After dialysis, despite improvements in clinical and laboratory parameters, she had an episode of ventricular fibrillation and cardiac arrest which was promptly reverted. She was still oliguric but without neurological deficits. A laboratory work up for multiple myeloma was started. Serum protein  electrophoresis showed hypogammaglobulinemia without a monoclonal peak. While on laboratory work up, the patient had another episode of ventricular fibrillation and died. The autopsy showed left renal vein thrombosis, bone marrow involvement by a plasmacytic myeloma, light-chain deposition disease with diffuse glomerular and tubular involvement and also myeloma cast nephropathy. This case illustrates a rarely documented association between myeloma cast nephropathy, renal light-chain deposition disease and renal vein thrombosis in a multiple myeloma patient with acute renal failure.
%K Mieloma m迆ltiplo
%K Aut車psia
%K Trombose
%K Les o renal aguda
%K Prote赤nas do mieloma.
%U http://www.revistas.usp.br/autopsy/article/view/36418