Abstract
The initial investigations revealed serum creatinine: 1.05 mg/dL, serum potassium: 3.1 mEq/L, hemoglobin: 9.0 g/dL, erythrocyte sedimentation rate: 125 mm after 1st h, total serum proteins: 5.6 g/dL, serum albumin: 1.6 g/dL, total cholesterol: 172 mg/dL, triglycerides: 276 mg/dL, serum calcium: 8.2 mg/dL, serum phosphorus: 3.4 mg/dL, serum uric acid: 8.9 mg/dL, 24 h urine protein: 3.1 g, urine albumin: 1+, urine red blood cells: nil, and urine white blood cells: 2–4/hpf. [3] Our patient had no features of myeloma cast nephropathy on renal biopsy but had mesangial proliferative glomerulonephritis (GN) with mesangial IgA deposition, which is a characteristic pattern of IgA nephropathy and HSP nephritis. A monoclonal component consisting of IgG light chain was found in serum and bone marrow aspiration material that consisted of 10% of plasma cells confirming multiple myeloma.
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1 Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh
2 Department of Medicine, Vydehi Institute of Medical Sciences, Bengaluru, Karnataka