Disappearance of nodular mesangial lesions in a patient with light chain nephropathy after long-term chemotherapy

A 64-year-old man developed multiple myeloma (kappa light chain type), neph rotic syndrome, and renal insufficiency in 1993, A renal biopsy showed typi cal histological findings of light chain nephropathy: nodular glomeruloscle rosis with deposition of kappa light chains in the mesangial area and suben dothelial space of the glomerular capillary walls. Long-term intermittent M EVP chemotherapy (melphalan, 4 mg/d for 4 days; cyclophosphamide, 100 mg/d for 4 days; vincristine, 1 mg/d; prednisolone, 40 mg/d for 4 days) diminish ed proteinuria and improved renal function. In April 1999, a follow-up biop sy showed remarkable diminution of nodular lesions and disappearance of kap pa light chain deposits. Although the prognosis of light chain nephropathy has been considered poor, long-term successful chemotherapy can clear light chain deposits and restore renal function. (C) 2000 by the National Kidney Foundation, Inc.