Crystal nephropathy: - a variant form of myeloma kidney - a case report and review of the literature

Cast nephropathy is the most common form of myeloma kidney, and also one of the major determinants of a patient's prognosis. We experienced a case of multiple myeloma with acute renal failure that was associated with massive crystal deposition in kidney and bone marrow. Large crystal formation in my eloma kidney is a rare pathological finding in renal biopsies. In the liter ature, most of the cases with multiple myeloma with extracellular crystal d eposition often have a rapidly progressive course with a poor prognosis. Ba ll et al. [1993] suggested that this type of extracellular crystal depositi on be designated as "crystal globulinemia syndrome". The characteristics of the clinical and histopathological features, rapid progression and poor ou tcome, and crystal formation in the tubules found in the present case and i n those previously reported, support the proposal of a new concept of "crys tal nephropathy".