A patient with light chain disease may develop a renal Fanconi syndrome, which may be partial or complete.


Clinical features:

(1) light chain disease, usually with kappa light chain, secondary to a plasma cell dyscrasia

(2) aminoaciduria

(3) renal glycosuria

(4) phosphaturia

(5) renal tubular acidosis (RTA)


Diagnosis depends on:

(1) demonstrating Bence-Jones proteinuria

(2) presence of light chain crystals in the cytoplasm of proximal renal tubular epithelial cells, which are phosphotungstic acid-hematoxylin (PTAH) positive

(3) variable presence of light chain casts within the renal tubules

(4) exclusion of other causes of renal Fanconi syndrome


To read more or access our algorithms and calculators, please log in or register.