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Case Reports: Rare disease
Unusual cause of light chain cast nephropathy
  1. Kai Wen Chen1,
  2. David Owen Rees1,
  3. David Watson2 and
  4. Mared Owen-Casey3
  1. 1Nephrology Department, Betsi Cadwaladr University Health Board, Wrexham, UK
  2. 2Haematology Department, Betsi Cadwaladr University Health Board, Wrexham, UK
  3. 3Histopathology Department, Betsi Cadwaladr University Health Board, Rhyl, UK
  1. Correspondence to Dr Kai Wen Chen; kaiwenchen8{at}gmail.com

Abstract

Acute kidney injury due to light chain cast nephropathy is increasingly recognised in patients with haematological malignancies; however, the management and prognosis of this disease remain poorly understood. We describe a case of a 78-year-old woman with known chronic lymphocytic leukaemia (CLL) who presented with fatigue and weight loss. She was found to have acute kidney injury, which rapidly worsened during admission. Kidney biopsy showed light chain cast nephropathy and bone marrow biopsy confirmed B-cell CLL. She was started on ibrutinib, halting further deterioration in her renal function and avoiding renal replacement therapy in the first 8 months.

  • haematology (incl blood transfusion)
  • acute renal failure
  • renal medicine
  • haematology (drugs and medicines)

https://doi.org/10.1136/bcr-2021-246777

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    Footnotes

    • Contributors KWC conducted literature review and wrote case report. DOW supervised and edited case report. DW provided haematology guidance and edited case report. MO-C interpreted slides and provided images of slides.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.