June 5, 2017
Diagnose This! (June 5, 2017)

- Published: June 5, 2017
- By: L. Nich Cossey, MD
- Tags: Acute kidney injury, Crystalline inclusions, Fanconi syndrome, LCPT, Light chain proximal tubulopathy, MGRS, Monoclonal gammopathy of renal significance, Proteinuria
What’s your diagnosis?
These photomicrographs show rhomboid-shaped crystals within proximal tubular cytoplasm on EM and Toluidine blue stain. Although not shown, these crystals showed intense lambda light stain restriction on immunofluorescence confirming a crystalline-type light chain proximal tubulopathy. And, in this patient with Fanconi syndrome and a lambda light chain restricted MGUS, these findings fit within the spectrum of monoclonal gammopathy of renal significance.