Rare onset of myeloma disease in the form of acute kidney injury
https://doi.org/10.21886/2219-8075-2026-17-1-5-10
Abstract
This article presents the case history of patient B., 63, with an atypical onset of multiple myeloma, manifested by acute kidney injury. This description of a clinical case of this rare onset of multiple myeloma is important for physicians of various specialties, as it demonstrates the variability of the course of extraosseous lesions in this disease, as well as the specific features of renal tissue involvement. Specifically, the classic variant of cast nephropathy in patient B. was masked by the absence of pathological changes in the urine and signs of paraprotein accumulation in the blood, which reduces the likelihood of an accurate diagnosis and, consequently, timely treatment. Importantly, the described changes in renal tissue indicate severe nephrotoxicity of the paraprotein and the rapid development of renal injury.
About the Authors
M. M. Batiushin
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Mikhail M. Batiushin, Dr. Sci. (Med.), Professor, Professor of the Department of Internal Medicine No. 2
Rostov-on-Don
Competing Interests:
Authors declare no conflict of interest.
I. N. Nesterenko
Rostov State Medical University; Rostov Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Irina N. Nesterenko, nephrologist, Rostov Regional Clinical Hospital, Assistant Professor, Department of Reconstructive, Cardiovascular, Thoracic, Maxillofacial Surgery and Transplantology
Rostov-on-Don
Competing Interests:
Authors declare no conflict of interest.
T. P. Beloborodova
Regional Clinical Hospital No. 2
Russian Federation
Competing Interests:
Russian Federation
Tatyana P. Beloborodova, Nephrologist, Department of Chronic Hemodialysis
Rostov-on-Don
Competing Interests:
Authors declare no conflict of interest.
N. B. Strakhova
Regional Clinical Hospital No. 2
Russian Federation
Competing Interests:
Russian Federation
Natalia B. Strakhova, Head of the Chronic Hemodialysis Department
Rostov-on-Don
Competing Interests:
Authors declare no conflict of interest.
E. S. Levitskaya
Rostov State Medical University
Russian Federation
Competing Interests:
Russian Federation
Ekaterina S. Levitskaya, Dr. Sci. (Med.), Associate Professor, Head of the Department of Medical Rehabilitation, Professor at the Department of Internal Diseases No. 2
Rostov-on-Don
Competing Interests:
Authors declare no conflict of interest.
References
1. Zakharova E.V., Zykova A.S., Makarova T.A., Leonova E.S., Nikitina E.N. et al. Clinical and pathology characteristics of 197 patients with monoclonal gammopathies of renal significance and paraprotein-related kidney damage in malignant lymphoproliferative disorders. Nephrology and Dialysis. 2024;26(1):55-70. (In Russ.) DOI: 10.28996/2618-9801-2024-1-55-70.
2. Khrabrova M.S., Dobronravov V.A., Smirnov A.V. Kidney disease associated with monoclonal gammopathies: single-center study. Nephrology. 2018;22(6):38–46 (In Russ.). DOI: 10.24884/1561-6274-2018-22-6-38-46
3. Smirnov A.V., Afanasyev B.V., Poddubnaya I.V., Dobronravov V.A., Khrabrova M.S. et al. Monoclonal gammopathy of renal ignify cance: Consensus of hematologists and nephrologists of Russia on the establishment of nosology, diagnostic approach and rationale for clone specifi c treatment. Nephrology. 2019;23(6):9-28. (In Russ.) DOI: 10.36485/1561-6274-2019-23-6-9-28.
4. Rekhtina IG, Golitsina EP, Varlamova Eiu, Varshavskiĭ VA, Kireeva AA, et al. The morphological and immunochemical features of nephropathies in multiple myeloma and severe renal failure. Therapeutic Archive. 2013;85(3):80 85. (In Russ.)
5. Mene P, Stoppacciaro A, Lai S, Festuccia F. Light Chain Cast Nephropathy in Multiple Myeloma: Prevalence, Impact and Management Challenges. Int J Nephrol Renovasc Dis. 2022;15:173-183. DOI: 10.2147/IJNRD.S280179.
6. Thajudeen B, Rubin MF. Hemodynamic acute kidney injury in immunoglobulin A nephropathy: nephrosarca theory revisited. Am J Med. 2013;126(12):e13–4. DOI: 10.1016/j.amjmed.2013.07.033.
7. Oyama Y, Iwafuchi Y, Morioka T, Narita I. Acute kidney injury associated with minimal change nephrotic syndrome in an elderly patient successfully treated with both fluid management and specific therapy based on kidney biopsy findings. Case Rep Nephrol Dial. 2020;10(1):42–50. DOI: 10.1159/000507426
8. Borodina L.V., S.A. Kozakova, Rybas A.V. A case of multiple myeloma that debuted with acute kidney injury. Therapy. 2024;10(S1,73):36.
9. Rekhtina I.G., Kazarina E.V., Stolyarevich E.S., Kulikov S.M., Dvirnyk V.N., Mendeleeva L.P. Interstitial fibrosis and outcomes of acute kidney injury in myeloma cast nephropathy. Nephrology and Dialysis. 2019;21(3):312-319. (In Russ.) DOI: 10.28996/2618-9801-2019-3-312-319.
10. Sanders PW. Mechanisms of light chain injury along the tubular nephron. J Am Soc Nephrol. 2012;23(11):1777–1781. DOI: 10.1681/asn.2012040388.
11. Ying WZ, Wang PX, Aaron KJ, Basnayake K, Sanders PW. Immunoglobulin light chains activate nuclear factor κB in renal epithelial cells through a Src-dependent mechanism. Blood. 2011;117(4):1301–1307. DOI: 10.1182/blood-2010-08-302505.
12. Li L, Han C, Yu X, Cai Y, Cao Y, et al. Experimental Characteristics of Patients with Newly Diagnosed Multiple Myeloma. Altern Ther Health Med. 2023;29(8):529-533.
13. Liu X, Hu Q, Zheng Y, Tang W, Niu T. Incidence, Clinical Features, and Prognostic Value of New-Onset Renal Impairment in Multiple Myeloma. Cancer Med. 2025;14(21):e71361. DOI: 10.1002/cam4.71361.
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Review
For citations:
Batiushin M.M., Nesterenko I.N., Beloborodova T.P., Strakhova N.B., Levitskaya E.S. Rare onset of myeloma disease in the form of acute kidney injury. Medical Herald of the South of Russia. 2026;17(1):5-10. (In Russ.) https://doi.org/10.21886/2219-8075-2026-17-1-5-10
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