American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Medical Case Reports. 2021, 9(3), 167-169
DOI: 10.12691/ajmcr-9-3-9
Open AccessCase Report

Light Chain Cast Nephropathy in an African-American Woman with Waldenström’s Macroglobulinemia

Mohamedanwar Ghandour1, , Ahmed Abdalrahem2, Hammam Shereef3, Yahya Osman-Malik1 and Hillel Sternlicht1

1Department of Internal Medicine- Division of Nephrology, Wayne State University

2Department of internal medicine, Wayne State University

3Department of internal medicine, Beaumont Health System

Pub. Date: January 13, 2021

Cite this paper:
Mohamedanwar Ghandour, Ahmed Abdalrahem, Hammam Shereef, Yahya Osman-Malik and Hillel Sternlicht. Light Chain Cast Nephropathy in an African-American Woman with Waldenström’s Macroglobulinemia. American Journal of Medical Case Reports. 2021; 9(3):167-169. doi: 10.12691/ajmcr-9-3-9


Waldenström's macroglobulinemia (WM) is a rare cancer of the lymphatic system due to excess IgM monoclonal protein with a rare renal involvement. We describe a case of MW presenting with acute renal failure. A 63-year-old female who was admitted to our hospital for influenza B complicated by acute renal failure during the hospital stay, with creatinine up to 6 mg/dL, despite adequate hydration. Electrophoresis revealed a monoclonal component in the gamma region, which was classified as an IgM k. A kidney biopsy was performed, showing light cast chains suggested the possibility of myeloma kidney. Furthermore, bone marrow histology was performed, revealing lymphoplasmacytic lymphoma. The patient was treated with bortezomib, dexamethasone, and cyclophosphamide, with complete recovery of renal function (creatinine 1.1 mg/dL).

Waldenström's macroglobulinemia light cast chain nephropathy

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Waldenström macroglobulinaemia.AUFonseca R, Hayman S SOBr J Haematol. 2007; 138(6): 700.
[2]  Waldenström's macroglobulinemia: incidence patterns in the United States, 1988-1994.AUGroves FD, Travis LB, Devesa SS, Ries LA, Fraumeni JF Jr SOCancer. 1998; 82(6): 1078.
[3]  Overall survival and competing risks of death in patients with Waldenström macroglobulinaemia: an analysis of the Surveillance, Epidemiology and End Results database. AUCastillo JJ, Olszewski AJ, Kanan S, Meid K, Hunter ZR, Treon SP SOBr J Haematol. 2015 Apr; 169(1): 81-9. Epub 2014 Dec 18.
[4]  Fifty-Year Incidence of Waldenström Macroglobulinemia in Olmsted County, Minnesota, From 1961 Through 2010: A Population-Based Study With Complete Case Capture and Hematopathologic Review. AUKyle RA, Larson DR, McPhail ED, Therneau TM, Dispenzieri A, Kumar S, Kapoor P, Cerhan JR, Rajkumar SV SOMayo Clin Proc. 2018;93(6):739. Epub 2018 Apr 12.
[5]  Myeloma and race: a review of the literature.AUBenjamin M, Reddy S, Brawley OW SOCancer Metastasis Rev. 2003; 22(1): 87.
[6] 2141.2001.03144.x
[7]  Renal disease related to Waldenström macroglobulinaemia: incidence, pathology and clinical outcomes.Vos JM, Gustine J, Rennke HG, Hunter Z, Manning RJ, Dubeau TE, Meid K, Minnema MC, Kersten MJ, Treon SP, Castillo JJ Br J Haematol. 2016 Nov; 175(4): 623-630.
[8]  Renal pathology of Waldenström's macroglobulinaemia with monoclonal antiglomerular antibodies and nephrotic syndrome. Lindström FD, Hed J, Eneström SClin Exp Immunol. 1980; 41(2): 196.
[9]  Pathology of the kidney in Waldenström's macroglobulinemia. Study of sixteen cases. Morel-Maroger L, Basch A, Danon F, Verroust P, Richet G SON Engl J Med. 1970; 283(3): 123.
[10]  Renal disease in Waldenström's macroglobulinaemia.Veltman GA, van Veen S, Kluin-Nelemans JC, Bruijn JA, van Es LA.Nephrol Dial Transplant. 1997; 12(6): 1256.
[11]  Treon S P, Xu L, Yang G, Zhou Y, Liu X, Cao Y, Sheehy P, Manning RJ, Patterson CJ, Tripsas C, Arcaini L, Pinkus GS, Rodig SJ, Sohani AR, Harris NL, Laramie JM, Skifter DA, Lincoln SE, Hunter ZR. MYD88 L265P somatic mutation in Waldenstrom's macroglobulinemia. N Engl J Med. 2012; 367: 826-833.
[12]  Xu L, Hunter ZR, Yang G, Zhou Y, Cao Y, Liu X, Morra E, Trojani A, Greco A, Arcaini L, Varettoni M, Brown JR, Tai YT, Anderson KC, Munshi NC, Patterson CJ, Manning RJ, Tripsas CK, Lindeman NI, Treon SP. MYD88 L265P in Waldenstrom's macroglobulinemia, IgM monoclonal gammopathy, and other B-cell lymphoproliferative disorders using conventional and quantitative allele-specific PCR. Blood 2013.
[13]  Treon SP, Cao Y, Xu L, Yang G, Liu X, Hunter ZR. Somatic mutations in MYD88 and CXCR4 are determinants of clinical presentation and overall survival in Waldenstrom's macroglobulinemia. Blood. 2014.
[14]  Hunter ZR, Xu L, Yang G, Zhou Y, Liu X, Cao Y, Manning RJ, Tripsas C, Patterson CJ, Sheehy P, Treon SP. The genomic landscape of Waldenstrom macroglobulinemia is characterized by highly recurring MYD88 and WHIM-like CXCR4 mutations, and small somatic deletions associated with B-cell lymphomagenesis. Blood 2014; 123: 1637-1646.
[15]  Multiple myeloma and severe renal failure: a clinicopathologic study of outcome and prognosis in 34 patients.Rota S, Mougenot B, Baudouin B, De Meyer-Brasseur M, Lemaitre V, Michel C, Mignon F, Rondeau E, Vanhille P, Verroust P Medicine (Baltimore). 1987; 66(2): 126.
[16]  Renal failure in multiple myeloma. Pathogenesis and prognostic implications.Alexanian R, Barlogie B, Dixon D.Arch Intern Med. 1990; 150(8): 1693.
[17]  Renal failure in multiple myeloma: presenting features and predictors of outcome in 94 patients from a single institution.BladéJ, Fernández-Llama P, Bosch F, Montolíu J, Lens XM, Montoto S, Cases A, Darnell A, Rozman C, Montserrat E Arch Intern Med. 1998; 158(17): 1889.