Antibodies are comprised of the structure noted on the left: they have two immunoglobulin heavy chains (in blue) and two immunoglobulin light chains (in green), covalently linked with one another via disulfide bonds (in red). The light chains…
I had always assumed that the “Bence-Jones” protein–essentially, the demonstration of monoclonal light chains on urine protein electropheresis (UPEP)–was named after two doctors, Bence & Jones. However I recently found out that actually it was named after a…
Quick case summary as presented in Renal Grand Rounds today: A 54 year-old man presents with altered mental status, a sky-high ammonia level (>200) and anemia requiring blood transfusion. Other unusual lab values include hypophosphatemia and hypokalemia with…
A question which comes up not infrequently during nephrology fellowship is whether or not to perform pheresis on patients with multiple myeloma. Once very much in vogue, the results of a fairly recent (Annals of Internal Medicine, 2005)…
Multiple myeloma and renal disease often go hand-in-hand, and it has a differential diagnosis which is fascinating in terms of its breadth. Although we often diagnosis many of these patients with “cast nephropathy”, my suspicion is that some…
