Blood is Always Thicker than Water – A Case of Renal Involvement in Waldenstrom’s Macroglobulinemia

A 41-year-old man presented with nonspecific complaints of nausea, vomiting, and generalized fatigue for 2 months. He had renal dysfunction and severe anemia, for which he underwent acute peritoneal dialysis and four packed red blood cell transfusions at another hospital. Sampling his blood for labo...

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Main Authors: Mohammed Fahad Khan, Ravi Jangamani, Mahesha Vankalakunti, H. Sudarshan Ballal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Indian Journal of Kidney Diseases
Subjects:
Online Access:https://journals.lww.com/10.4103/ijkd.ijkd_15_23
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author Mohammed Fahad Khan
Ravi Jangamani
Mahesha Vankalakunti
H. Sudarshan Ballal
author_facet Mohammed Fahad Khan
Ravi Jangamani
Mahesha Vankalakunti
H. Sudarshan Ballal
author_sort Mohammed Fahad Khan
collection DOAJ
description A 41-year-old man presented with nonspecific complaints of nausea, vomiting, and generalized fatigue for 2 months. He had renal dysfunction and severe anemia, for which he underwent acute peritoneal dialysis and four packed red blood cell transfusions at another hospital. Sampling his blood for laboratory evaluation was difficult as the sample would repeatedly clot before the machine could assess the same. It was found that the patient had hyperproteinemia, with hyperviscosity which was causing the same. Further evaluation revealed a monoclonal gammopathy, which was IgM predominant, and bone marrow evaluation revealed Waldenstrom’s macroglobulinemia (WM). Renal biopsy also showed light-chain cast nephropathy. The patient underwent three sessions of plasmapheresis and was initiated on chemotherapy and showed symptomatic and laboratory improvement. This case reveals renal involvement in WM, which is rare and highlights the difficulty faced in evaluating the plasma samples of the patient for laboratory investigations.
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issn 2950-0761
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publishDate 2023-01-01
publisher Wolters Kluwer Medknow Publications
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series Indian Journal of Kidney Diseases
spelling doaj-art-86c684ad08dd4f8090ee97121a3596062025-08-20T02:05:17ZengWolters Kluwer Medknow PublicationsIndian Journal of Kidney Diseases2950-07612023-01-0121283110.4103/ijkd.ijkd_15_23Blood is Always Thicker than Water – A Case of Renal Involvement in Waldenstrom’s MacroglobulinemiaMohammed Fahad KhanRavi JangamaniMahesha VankalakuntiH. Sudarshan BallalA 41-year-old man presented with nonspecific complaints of nausea, vomiting, and generalized fatigue for 2 months. He had renal dysfunction and severe anemia, for which he underwent acute peritoneal dialysis and four packed red blood cell transfusions at another hospital. Sampling his blood for laboratory evaluation was difficult as the sample would repeatedly clot before the machine could assess the same. It was found that the patient had hyperproteinemia, with hyperviscosity which was causing the same. Further evaluation revealed a monoclonal gammopathy, which was IgM predominant, and bone marrow evaluation revealed Waldenstrom’s macroglobulinemia (WM). Renal biopsy also showed light-chain cast nephropathy. The patient underwent three sessions of plasmapheresis and was initiated on chemotherapy and showed symptomatic and laboratory improvement. This case reveals renal involvement in WM, which is rare and highlights the difficulty faced in evaluating the plasma samples of the patient for laboratory investigations.https://journals.lww.com/10.4103/ijkd.ijkd_15_23cast nephropathyhyperviscositywaldenstrom’s macroglobulinemia
spellingShingle Mohammed Fahad Khan
Ravi Jangamani
Mahesha Vankalakunti
H. Sudarshan Ballal
Blood is Always Thicker than Water – A Case of Renal Involvement in Waldenstrom’s Macroglobulinemia
Indian Journal of Kidney Diseases
cast nephropathy
hyperviscosity
waldenstrom’s macroglobulinemia
title Blood is Always Thicker than Water – A Case of Renal Involvement in Waldenstrom’s Macroglobulinemia
title_full Blood is Always Thicker than Water – A Case of Renal Involvement in Waldenstrom’s Macroglobulinemia
title_fullStr Blood is Always Thicker than Water – A Case of Renal Involvement in Waldenstrom’s Macroglobulinemia
title_full_unstemmed Blood is Always Thicker than Water – A Case of Renal Involvement in Waldenstrom’s Macroglobulinemia
title_short Blood is Always Thicker than Water – A Case of Renal Involvement in Waldenstrom’s Macroglobulinemia
title_sort blood is always thicker than water a case of renal involvement in waldenstrom s macroglobulinemia
topic cast nephropathy
hyperviscosity
waldenstrom’s macroglobulinemia
url https://journals.lww.com/10.4103/ijkd.ijkd_15_23
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