Cisplatin-Induced Nephrotoxicity and HIV Associated Nephropathy: Mimickers of Myeloma-Like Cast Nephropathy

Myeloma cast nephropathy is an obstructing disorder of renal tubules, caused by precipitation of Bence Jones proteins. Myeloma-like cast nephropathy (MLCN) has been reported in the literature to occur in various primary renal and nonrenal diseases. We present a series of three rare cases of cast nep...

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Main Authors: Muhammad Siddique Khurram, Ahmed Alrajjal, Warda Ibrar, Jacob Edens, Umer Sheikh, Ameer Hamza, Hong Qu
格式: Article
語言:English
出版: Wiley 2017-01-01
叢編:Case Reports in Nephrology
在線閱讀:http://dx.doi.org/10.1155/2017/6258430
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author Muhammad Siddique Khurram
Ahmed Alrajjal
Warda Ibrar
Jacob Edens
Umer Sheikh
Ameer Hamza
Hong Qu
author_facet Muhammad Siddique Khurram
Ahmed Alrajjal
Warda Ibrar
Jacob Edens
Umer Sheikh
Ameer Hamza
Hong Qu
author_sort Muhammad Siddique Khurram
collection DOAJ
description Myeloma cast nephropathy is an obstructing disorder of renal tubules, caused by precipitation of Bence Jones proteins. Myeloma-like cast nephropathy (MLCN) has been reported in the literature to occur in various primary renal and nonrenal diseases. We present a series of three rare cases of cast nephropathy, two of which are HIV patients, and the third patient is receiving cisplatin-based chemotherapy. However, in all three patients plasma cell dyscrasia has been ruled out. A 30-year-old male was admitted to the hospital with facial cellulitis. The second patient is a 31-year-old male who presented with Pneumocystis jiroveci pneumonia. The third patient was treated with cisplatin-based chemotherapy for carcinoma. First two cases revealed foci of diffuse tubular dilatation containing hyaline casts and interstitial inflammatory infiltrate, in addition to globally sclerotic glomeruli with ultrastructural foot process fusion and mesangium expansion. The third case showed acute tubular injury and cast formation of irregular casts composed of amorphous or granular material of low density admixed with scattered high electron-dense globules. Myeloma-like cast nephropathy and true myeloma cast nephropathy pose similar destructive effects on renal parenchyma. This new pattern of HIV-related nephropathy should be considered in HIV patients with MLCN, once monoclonal gammopathy is ruled out.
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spelling doaj.art-1f59aae84fa24924a901b85180ec452c2025-02-03T01:24:11ZengWileyCase Reports in Nephrology2090-66412090-665X2017-01-01201710.1155/2017/62584306258430Cisplatin-Induced Nephrotoxicity and HIV Associated Nephropathy: Mimickers of Myeloma-Like Cast NephropathyMuhammad Siddique Khurram0Ahmed Alrajjal1Warda Ibrar2Jacob Edens3Umer Sheikh4Ameer Hamza5Hong Qu6St. John Hospital and Medical Center, Detroit, MI, USASt. John Hospital and Medical Center, Detroit, MI, USASt. John Hospital and Medical Center, Detroit, MI, USASt. John Hospital and Medical Center, Detroit, MI, USASt. John Hospital and Medical Center, Detroit, MI, USASt. John Hospital and Medical Center, Detroit, MI, USASt. John Hospital and Medical Center, Detroit, MI, USAMyeloma cast nephropathy is an obstructing disorder of renal tubules, caused by precipitation of Bence Jones proteins. Myeloma-like cast nephropathy (MLCN) has been reported in the literature to occur in various primary renal and nonrenal diseases. We present a series of three rare cases of cast nephropathy, two of which are HIV patients, and the third patient is receiving cisplatin-based chemotherapy. However, in all three patients plasma cell dyscrasia has been ruled out. A 30-year-old male was admitted to the hospital with facial cellulitis. The second patient is a 31-year-old male who presented with Pneumocystis jiroveci pneumonia. The third patient was treated with cisplatin-based chemotherapy for carcinoma. First two cases revealed foci of diffuse tubular dilatation containing hyaline casts and interstitial inflammatory infiltrate, in addition to globally sclerotic glomeruli with ultrastructural foot process fusion and mesangium expansion. The third case showed acute tubular injury and cast formation of irregular casts composed of amorphous or granular material of low density admixed with scattered high electron-dense globules. Myeloma-like cast nephropathy and true myeloma cast nephropathy pose similar destructive effects on renal parenchyma. This new pattern of HIV-related nephropathy should be considered in HIV patients with MLCN, once monoclonal gammopathy is ruled out.http://dx.doi.org/10.1155/2017/6258430
spellingShingle Muhammad Siddique Khurram
Ahmed Alrajjal
Warda Ibrar
Jacob Edens
Umer Sheikh
Ameer Hamza
Hong Qu
Cisplatin-Induced Nephrotoxicity and HIV Associated Nephropathy: Mimickers of Myeloma-Like Cast Nephropathy
Case Reports in Nephrology
title Cisplatin-Induced Nephrotoxicity and HIV Associated Nephropathy: Mimickers of Myeloma-Like Cast Nephropathy
title_full Cisplatin-Induced Nephrotoxicity and HIV Associated Nephropathy: Mimickers of Myeloma-Like Cast Nephropathy
title_fullStr Cisplatin-Induced Nephrotoxicity and HIV Associated Nephropathy: Mimickers of Myeloma-Like Cast Nephropathy
title_full_unstemmed Cisplatin-Induced Nephrotoxicity and HIV Associated Nephropathy: Mimickers of Myeloma-Like Cast Nephropathy
title_short Cisplatin-Induced Nephrotoxicity and HIV Associated Nephropathy: Mimickers of Myeloma-Like Cast Nephropathy
title_sort cisplatin induced nephrotoxicity and hiv associated nephropathy mimickers of myeloma like cast nephropathy
url http://dx.doi.org/10.1155/2017/6258430
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