Benign monoclonal gammopathy turning to AL amyloidosis after kidney transplantation

The fate of preexisting benign monoclonal gammopathy after organ transplant ation is largely unknown, We report the case of a 47-year-old male kidney g raft recipient with a pretransplantation IgG kappa monoclonal gammopathy wh o developed, 10 years after transplantation, de novo augloid light chain (A L) amyloidosis involving skin and kidney graft. The potential role of heavy immunosuppressive treatment In the development of this complication is dis cussed. The possible occurrence of AL amyloidosis should be kept in mind wh en a patient with benign monoclonal gammopathy is evaluated for organ trans plantation, as well as when a transplanted patient with pre-existing monocl onal gammopathy develops new onset of proteinuria. (C) 1999 by the National Kidney Foundation, Inc.