Early light chain deposition nephropathy: a clinicopathologic study of 3 cases with review of literatures
WANG Ming-yue
QU Li-juan
ZHENG Zhi-yong
Abstract：Purpose To investigate the clinical and pathological characteristics and diagnosis of the early light chain deposition nephropathy (LCDN),and to improve the recognition of the disease.Methods Clinical data of the three cases of early LCDN were analyzed by light microscopy,electron microscopy and the immunohistochemical staining retrospectively,and we reviewed some pertinent literatures.Results Among the 3 cases,2 were old males and one was middle-aged female.All of the three patients had large amount of proteinuria,the first two patients' original symptom was edema,and the third patient was diagnosed as myeloma.Case 1 showed mild glomerular mesangial proliferation and diffuse swelling of epithelial cells of the proximal convoluted tubule in light microscopy,and discontinuous linear electron-dense deposit inside tubular basement membrane in electron microscopy,and immunohistochemical study revealed positive staining of a single type of light chain in cytoplasma of proximal convoluted tubule epithelial cell,and this case was diagnosed as light chain cast nephropathy.In Case 2,glomerule was showed membranous nephropathy (Ⅰ ～ Ⅱ),and monoclonal λ light-chain deposition were demonstrated in mesangial area by immunohistochemical staining,which was the clue of the early light chain deposition nephropathy.In Case 3,glomerular changed minimally and λ light-chain deposited in mesangial area,the arterial wall and protein cast area strongly,at the same place κ light-chain deposition was weak,and it was diagnosed as minimal changed light chain deposition nephropathy.Conclutions The early LCDN has no typical structure of nodular glomerulosclerosis,glomerular and renal tubular could change slightly,and that could not be easy to diagnose.Immunolabeling of light-chain protein by immunohistochemical staining and electron microscopy carries further diagnostic value.
Keywords：Light-chain depositionNephropathyEarlyImmunopathogenesisElectron microscopy
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 423-426 )