Fibrillary Nephropathy and Amyloidosis - Two Morphological Faces of the Myeloma Kidney

Abstract

Myeloma-induced renal failure is associated with sig- nificant morbidity and mortality. Rapid intervention is critical to reverse kidney damage and improve renal function. We report two cases, one with fibrillary nephropathy and other one with kidney amyloidosis due to multiple myeloma, diagnosed by renal biopsy and treated in our department. Both patients had no other signs of multiple myeloma present, apart from acute renal failure and histological findings on renal biopsy. The renal biopsy was performed because of acute renal failure to exclude rapidly progressive glomerulo- nephritis. The histological analysis showed fibrillary glomerulopathy in one patient and kidney amyloidosis in the other, changes consistent with the diagnosis of multiple myeloma with kidney involvement. Further clinical investigation confirmed multiple myeloma and the patients treated accordingly.