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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2015  |  Volume : 26  |  Issue : 5  |  Page : 970-975
A case of primary renal allograft dysfunction due to myeloma cast nephropathy


1 Department of Nephrology, Institute of Nephro Urology, Bengaluru, Karnataka, India
2 Department of Pathology, Manipal Hospital, Bengaluru, Karnataka, India

Correspondence Address:
Umesh Lingaraj
Department of Nephrology Institute of Nephro-Urology, Victoria Hospital Campus, Bengaluru, Karnataka - 560 002
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-2442.164581

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We report a rare case of primary renal allograft dysfunction due to myeloma cast nephropathy in a patient with no overt clinical features of multiple myeloma preceding his transplantation. A 45-year-old man on hemodialysis for six months for end-stage kidney disease due to presumed chronic glomerulonephritis developed immediate graft dysfunction post-transplantation. The graft biopsy was diagnostic of myeloma cast nephropathy. Other criteria for lambda light chain multiple myeloma were fulfilled with immunofixation electrophoresis and bone marrow biopsy. He was treated with plasmapheresis, bortezomib and high-dose dexamethasone. However, the patient succumbed to septicemia on the 37 th post-operative day. This is probably the first report of primary renal allograft dysfunction due to myeloma cast nephropathy diagnosed within the first week posttransplanation in a patient with unrecognized multiple myeloma.


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