2016, Cilt 25, Sayı 0, Sayfa(lar) 098-102
Multiple Myeloma with Renal Involvement Presenting with Atypical Clinical Findings
DOI 10.5262/tndt.2016.21
Ahmet BEHLÜL1, Meltem GÜRSU1, Abdullah ŞUMNU1, Egemen CEBECİ1, Oktay ÖZKAN1
1Haseki Eğitim ve Araştırma Hastanesi, Nefroloji Bölümü, İstanbul, Türkiye
2İstanbul Üniversitesi İstanbul Tıp Fakültesi, Patoloji Anabilim Dalı, İstanbul, Türkiye
Keywords: Multiple myeloma, Acute kidney injury, Non-small cell lung cancer

Multiple myeloma (MM) is a multisystem disorder where renal involvement worsens the prognosis significantly. Herein, we present two cases with an atypical clinical presentation.

A 38-year-old female presented to our clinic with acute kidney injury (AKI) (urea: 47 mg/dl, creatinine: 3.0 mg/dl, calcium: 10.4 mg/dl, sedimentation: 49 mm/hour, proteinuria: 3.9 gr/day and urine sediment: 1-2 erythrocytes) after using gentamicin and nonsteroidal anti-inflammatory drugs (NSAIDs) for 6 weeks because of cystitis. Co-existence of cast nephropathy and IgA nephropathy was detected with renal biopsy while kappa light chain myeloma was detected with bone marrow biopsy. The second case was a 71-year-old male with normal preoperative creatinine levels while AKI developed following NSAID use after right lobectomy for non-small cell lung cancer (urea: 210 mg/dl, creatinine: 9.7 mg/dl, potassium: 6.1 mmol/L, calcium: 9.1 mg/dl, sedimentation: 63 mm/hour and proteinuria: 6 gr/day). The patient’s renal biopsy revealed cast nephropathy accompanied by nephrosclerosis. Lambda light chain myeloma was diagnosed with bone marrow biopsy.

MM should be kept in mind in patients who develop AKI after use of nephrotoxic drugs without additional risk factors for the development of AKI and in patients in a higher risk age group for MM.

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