PRESENTATION AND DIAGNOSIS Nearly 50% of patients with myeloma cast nephropathy have acute kidney injury; the remaining cases are either subacute or chronic. A typical presentation in a patient without…
TREATMENT Treatment of myeloma cast nephropathy centers on volume expansion, which reduces intratubular cast concentration, as well as chemotherapy (and sometimes plasmapheresis), which reduces serum free light chain concentration. The…
TREATMENT All patients with proteinuria, irrespective of the histologic class, should be treated with ACE inhibitors or ARBs. Hypertension should be strictly controlled. Hyperlipidemia should also be treated if present,…
In class IV (“diffuse LN”), the lesions are qualitatively similar to those of Class III but involve 50% or more of all glomeruli. In addition, there is often a more…
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PROGNOSIS In AL amyloidosis, the prognosis depends on the degree of systemic involvement (especially cardiac involvement) and the degree to which therapy reduces free light chain production. Although AL amyloidosis…
DIAGNOSIS OF SYSTEMIC LUPUS ERYTHEMATOSUS The American College of Rheumatology has proposed a list of 11 clinical, pathologic, and laboratory criteria that can be used to diagnose SLE. These include:…
Both AL and AA amyloidosis may also cause disease in other organ systems. Myocardial deposition is common, resulting in signs and symptoms of restrictive cardiomyopathy. Hepatic deposition leads to hepatomegaly…
PROGNOSIS A large study of type 2 diabetics found that the annual risk of progression from no albuminuria to microalbu-minuria was 2.0%, from microalbuminuria to macroalbuminuria was 2.8%, and from…
In type 1 diabetes, the pathologic changes to the glomerulus occur in a somewhat predictable sequence, with hypertrophy of the glomeruli and thickening of the basement membrane seen early in…
