A patient with multiple myeloma or other lymphoproliferative disorder with production of monoclonal lights chains may develop a crystalloid nephropathy.
Features of crystalloid nephropathy:
(1) myeloma with production of monoclonal light chains
(2) onset of renal impairment
(3) presence of crystalloid deposits in the renal tubules
Crystals may also be deposited in the bone marrow or circulating plasma cells (as pseudo-Auer rods). In theory the crystals may be excreted into the urine.
The condition may be rapidly progressive and have a poor prognosis. It may be easily overlooked in an elderly patient.
Differential diagnosis:
(1) myeloma kidney associated with renal casts
(2) other causes of acute renal failure
(3) crystalglobulinemia syndrome
(4) drug-induced crystal nephropathy
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