Renal crescentic alpha heavy chain deposition disease: a report of 3 cases and review of the literature

Am J Kidney Dis. 2011 Oct;58(4):621-5. doi: 10.1053/j.ajkd.2011.05.022.

Abstract

Heavy chain deposition disease (HCDD) is a comparatively recently described entity characterized by glomerular and tubular basement membrane deposition of monoclonal heavy chains without associated light chains. To our knowledge, review of the literature shows only 24 previously reported cases of HCDD with unequivocal evidence of monoclonal heavy chain deposition in the kidney using immunofluorescence microscopic and electron microscopic studies. The predominant heavy chain subtype was γ. There has been a single case of μ HCDD and 2 previously reported cases of α HCDD. In this report, we describe 3 additional cases of α HCDD, all with a crescentic pattern of injury and one of which was associated with cutis laxa. We compare their clinicopathologic features with all previously reported cases of HCDD.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Anemia / etiology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Boronic Acids / administration & dosage
  • Bortezomib
  • Cutis Laxa / etiology*
  • Dexamethasone / administration & dosage
  • Diabetic Nephropathies / etiology
  • Diabetic Nephropathies / immunology*
  • Erythropoietin / therapeutic use
  • Fatal Outcome
  • Female
  • Heavy Chain Disease / immunology*
  • Heavy Chain Disease / pathology
  • Hematuria / etiology
  • Humans
  • Hypertension, Renal / etiology
  • Immunoglobulin alpha-Chains / analysis
  • Immunoglobulin gamma-Chains / analysis
  • Immunoglobulin mu-Chains / analysis
  • Kidney Glomerulus / immunology
  • Kidney Glomerulus / pathology*
  • Male
  • Multiple Myeloma / complications*
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / drug therapy
  • Paraproteinemias / complications*
  • Paraproteinemias / diagnosis
  • Paraproteinemias / drug therapy
  • Proteinuria / etiology
  • Pyrazines / administration & dosage
  • Thalidomide / administration & dosage
  • Urticaria / etiology
  • Vasculitis, Leukocytoclastic, Cutaneous / etiology

Substances

  • Boronic Acids
  • Immunoglobulin alpha-Chains
  • Immunoglobulin gamma-Chains
  • Immunoglobulin mu-Chains
  • Pyrazines
  • Erythropoietin
  • Thalidomide
  • Bortezomib
  • Dexamethasone