I was recently rounding on a gentleman in the ICU with acute promyelocytic leukemia (APL) who, after starting induction therapy with tretinoin (all-trans retinoic acid), developed fever, hypotension, new pulmonary infiltrates with associated respiratory failure and AKI requiring…
Cancer-associated hypercalcemia is the #1 cause for hypercalcemia in the inpatient setting (in the outpatient setting, the main cause is primary hyperparathyroidism). In general, hypercalcemia of malignancy portends a poor prognosis, and there are three main mechanisms by…
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…
The winners of the 2009 Nobel Prize in Medicine were revealed today, shared by three Americans: Carol Greider, Elisabeth Blackburn, and Jack Szostak, the latter of whom works at my home institution of Massachusetts General Hospital. The award…
One of the major medical advances over the past few decades has been the success of stem cell transplants, which serves as a potential cure for many patients with previously untreatable leukemias and lymphomas. With the expanded use…
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…
Wilms Tumor–named after the German surgeon/pathologist Max Wilms (pictured at left)–is an embryonal tumor that derives from developing kidney tissue. Wilms was the first to postulate that tumors may arise from precursor cells which arise during development, and…
The dilemma: there are a subset of patients with some type of paraproteinemia–e.g., light chain deposition disease or amyloidosis, for instance–which are NEGATIVE by SPEP & UPEP. When there is renal involvement, the diagnosis can potentially be made…
As we all know, erythropoietin is secreted predominantly by the kidney (85% from the kidney, 15% from the liver) in response to hypoxia and its function is to stimulate erythropoiesis in the bone marrow. What is the receptor…
Cytoxan is a very potent but also potentially toxic medication used for a variety of immune-mediated (and nephrology-relevant) diseases. It is often classified as a “cytotoxic agent”, as it works as an alkylating agent that explains its utility…
