Collapsing Glomerulopathy in Lambda Light Chain Amyloidosis: A Report of 2 Cases. Am J Kidney Dis 2018 Oct;72(4):612-616
Date
06/18/2018Pubmed ID
29908693DOI
10.1053/j.ajkd.2018.04.009Scopus ID
2-s2.0-85048729413 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
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.
Author List
Khalighi MA, Gallan AJ, Chang A, Meehan SMAuthor
Alexander J. Gallan MD Assistant Professor in the Pathology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Acute Kidney InjuryAged
Amyloidosis
Antineoplastic Combined Chemotherapy Protocols
Biopsy, Needle
Combined Modality Therapy
Disease Progression
Female
Follow-Up Studies
Glomerular Mesangium
Glomerulonephritis
Humans
Immunohistochemistry
Kidney Glomerulus
Male
Nephrotic Syndrome
Renal Dialysis
Risk Assessment
Serum Amyloid A Protein
Time Factors
Treatment Outcome