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64岁女性患者,病程3月,以肉眼血尿起病,尿常规示大量镜下血尿及中等量蛋白尿,短期内血清肌酐升高、一过性高钙血症,中度贫血,骨髓浆细胞占45.5%,血清游离轻链比例明显异常,免疫固定电泳见λ型Ig G单克隆免疫球蛋白。肾活检病理免疫荧光仅见C3呈颗粒状弥漫分布于肾小球系膜区及毛细血管袢,组织学见肾小球节段内皮系膜增生伴系膜区、内皮下及基膜内嗜复红物沉积。最后诊断多发性骨髓瘤相关C3肾小球肾炎。
64-year-old female patient, the course of the disease in March, onset of gross hematuria, urine showed a large number of microscopic hematuria and moderate proteinuria, short-term serum creatinine, transient hypercalcaemia, moderate anemia, bone marrow plasma cells Accounting for 45.5%, serum free light chain was significantly abnormal immune fixed electrophoresis λ λ Ig monoclonal monoclonal immunoglobulin. Renal biopsy showed only pathological immunofluorescence C3 was diffusely distributed in the glomerular mesangial area and capillaries, histological see glomerular segments of mesangial hyperplasia with mesangial area, subendothelial and basilar membrane complex red Material deposition. The final diagnosis of multiple myeloma-related C3 glomerulonephritis.