To report a case of renal AL amyloidosis associated with Waldenström macroglobulinemia and review existing literature on the topic, highlighting its clinical significance.
Key Findings:
The patient had serum monoclonal IgMλ, nephrotic syndrome, moderate anemia, and lymphoplasmacytic infiltration in bone marrow, indicating the severity of her condition.
Renal biopsy confirmed renal AL amyloidosis with Congo red-positive deposits, underscoring the pathological findings.
The patient developed a severe pulmonary infection during treatment, leading to death, highlighting the risks associated with treatment.
Interpretation:
Patients with Waldenström macroglobulinemia should be routinely tested for serum and urine monoclonal free light chains, as they can lead to renal diseases, emphasizing the need for early detection.
Limitations:
The case highlights the need for monitoring treatment-related toxicities, particularly severe infections, and acknowledges potential biases in case reporting.
Conclusion:
The BR regimen is a reasonable first-line treatment for WM patients with renal AL amyloidosis, but careful monitoring for adverse effects, especially severe infections, is essential.
