Myeloma-like cast nephropathy in a human immunodeficiency virus infected patient: a case report

We report a case of myeloma-like cast nephropathy in a 27-year-old male patient with human immunodeficiency virus (HIV) infection for 2 years. He was on highly active anti-retroviral therapy (HAART) and presented with high grade fever, nausea and vomiting for 2 weeks. On investigations, he was found to have acute kidney injury (AKI). He was started on hemodialysis. Renal biopsy revealed acute tubulointerstitial nephritis with myeloma-like casts in a few tubular lumens. Detailed workup for multiple myeloma was negative. No evidence of monoclonal gammopathy was found. Finally, he was diagnosed as a case of myeloma-like cast nephropathy. With supportive treatment and modification in HAART therapy, his renal functions improved and he became dialysis free in 2 weeks. He was continued on HAART therapy, but he soon discontinued this against medical advice.

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Bibliographic Details
Main Authors: Jafry,Nazrul Hassan, Mubarak,Muhammad, Anis,Sabiha, Ahmed,Ejaz, Akhtar,Fazal
Format: Digital revista
Language:English
Published: Sociedade Portuguesa de Nefrologia 2019
Online Access:http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692019000200009
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Summary:We report a case of myeloma-like cast nephropathy in a 27-year-old male patient with human immunodeficiency virus (HIV) infection for 2 years. He was on highly active anti-retroviral therapy (HAART) and presented with high grade fever, nausea and vomiting for 2 weeks. On investigations, he was found to have acute kidney injury (AKI). He was started on hemodialysis. Renal biopsy revealed acute tubulointerstitial nephritis with myeloma-like casts in a few tubular lumens. Detailed workup for multiple myeloma was negative. No evidence of monoclonal gammopathy was found. Finally, he was diagnosed as a case of myeloma-like cast nephropathy. With supportive treatment and modification in HAART therapy, his renal functions improved and he became dialysis free in 2 weeks. He was continued on HAART therapy, but he soon discontinued this against medical advice.