Back
For best output, select "Paper Size" as "A4" and "Margin" as "0" or "None".
To save or print to PDF, please select Print Destination > Save as PDF, enable Background Graphics under "More Settings", then click "Save".
During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Light chain cast nephropathy is a kidney disorder primarily associated with myeloma. A heavy burden of filtered free light chains/Bence Jones protein, cause obstructive tubulopathy and/or direct toxicity promoting acute kidney injury and rapidly progressive renal failure. Factors, which may precipitate this phenomenon are dehydration, hypercalcemia, high-dose diuretics and nephrotoxic drugs (contrast agents, NSAIDs).
A 60-year-old female patient with a history of multiple myeloma (IgGκ) in partial remission under treatment presented markedly dehydrated with weakness, debilitation, low blood pressure, and reduced urine output. The last 7 days she had been suffering gastroenteritis and diarrhea.
At presentation, serum creatinine (Cr) was 16.3 mg/dl, Hct 21,7%, calcium 7.7mg/dl. Stool sample examination (PCR) and culture for enteric pathogens was negative. Serum protein electrophoresis (SPEP), immunofixation electrophoresis (IFE) and quantitative determination of serum immunoglobulins were normal (κ: 0.73mg/L, λ:0.09 mg/L) albeit κ-light chains were increased in urine (κ : 203 mg/L).
A renal biopsy was performed which showed the presence of eosinophilic, fragmented casts in the tubular lumen, exhibiting irregular, angulated, and geometric shapes with accumulation of inflammatory cells in their marginal parts. On immunofluorescence, intense positivity for κ-light chains in the intratubular casts was observed along with moderate fixation of monoclonal IgG while λ-light chains were negative. Focal interstitial fibrosis and mild infiltration by inflammatory cells (lymphocytes and macrophages) were also depicted.
Light-chain cast nephropathy was diagnosed.
The patient received parenteral fluid support while she was in need for a few haemodialysis treatments. The urine output gradually increased and kidney function improved.
Light chain cast nephropathy is a common cause of severe renal impairment in patients with multiple myeloma. The serum free light chain assay is used in patients with unexplained acute kidney injury to screen for potential myeloma related cast nephropathy. However, the range of free light chains at which cast nephropathy can occur is uncertain. The International Myeloma Working Group associated renal impairment as a consequence of myeloma cast nephropathy to a serum free light chain level above 1500 mg/L, whereas the International Kidney and Monoclonal Gammopathy Research Group proposed a serum free light chain level above 500 mg/L. Surprisingly, our patient had low serum free light chain (κ: 0.73mg/L), which made the diagnosis of light chain cast nephropathy improbable. Diarrheal syndrome and dehydration seemed to have played a pivotal role in the precipitation of casts in this case.
