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Nephrol Dial Transplant (2001) 16: 1939-1941
© 2001 European Renal Association-European Dialysis and Transplant Association

The Interesting Case

Light chain deposit disease: a frequent cause of diagnostic difficulty

Clive L. Hall1, and Danielle S. Peat2

1 Department of Nephrology, Royal United Hospital, Bath and 2 Department of Histopathology, Southmead Hospital, Bristol, UK

Keywords: LCDD; monoclonal gammopathy; nodular glomerulosclerosis; TBM thickening; diagnostic difficulty

Introduction

Light chain deposit disease (LCDD) [1] is an uncommon monoclonal gammopathy which should be considered carefully in patients who have both renal disease and a lymphoplasmacytic disorder capable of producing monoclonal light chains—myeloma, macroglobulinaemia, lymphoma, chronic lymphatic leukaemia [2–4]. The diagnosis is straightforward when monoclonal light chains are present in the serum and/or urine and the renal biopsy shows characteristic morphological changes and stains clearly for kappa or lambda light chains. The diagnosis of LCDD is often difficult as patients may not have a known or demonstrable lymphoplasmacytic disorder [3–5], monoclonal light chains may be detectable only intermittently and at low concentrations in the serum and/or urine [. . . [Full Text of this Article]

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