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Bir Hastada Kappa Hafif Zincir Hastalığıyla İlişkili Fokal Segmental Glomerüloskleroz

Focal Segmental Glomerulosclerosis in a Patient Associated with Kappa-Light Chain Disease

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DOI: 
DOI 10.5262/tndt.2011.1001.17
Abstract (2. Language): 
Focal segmental glomerulosclerosis is a non-inflammatory glomerulopathy associated with nephrotic syndrome and end-stage renal failure. Focal segmental glomerulosclerosis related to plasma cell disorder is not common. A 46-year-old man presented to our outpatient clinic with lumbar pain that had been present for two years. He had been taking non-steroid anti-inflammatory drugs for two years because of his pain. He had no history of any systemic disease. Physical examination revealed a body mass index of 20 kg/m2, blood pressure of 150/90 mmHg, 2+ bilateral lower extremity pitting edema and lumbar vertebrae sensitivity. We described a patient found to have nephrotic syndrome on the first medical examination, and lytic bone lesion and monoclonal gammopathy of the kappa light-chain type later on. A renal biopsy was performed and the histopathological findings were consisted with FSGS. Monoclonal gammopathy should be considered as the underlying disease in any patient diagnosed with focal segmental glomerulosclerosis.
Abstract (Original Language): 
Fokal segmental glomerüloskleroz nefrotik sendrom ve son dönem böbrek yetmezliğiyle ilişkili inflamatuvar olmayan bir glomerülopatidir. Monoklonal gamopatiye ikincil gelişen fokal glomerüloskleroz yaygın bir durum değildir. Kırk altı yaşında erkek hasta 2 yıldır devam eden bel ağrısıyla kliniğe başvurdu. Ağrı nedeniyle 2 yıldır non-steroid anti-inflamatuvar ilaç kullanım dışında sistemik bir hastalık öyküsü yoktu. Fizik muayenede, vücut kitle indeksi 20 kg/m2, kan basıncı 150/90 mmHg, bilateral alt ekstremitede 2+ gode bırakan ödem ve lomber vertebralarda duyarlılık mevcuttu. Burada ilk tıbbi incelemede nefrotik sendrom, daha sonra litik kemik lezyonları ve kappa hafif zincir monoklonal gamopati tespit edilen bir hasta tanımlanmıştır. Renal biyopsi sonrasında histopatolojik inceleme fokal segmental glomerülosklerozla uyumlu bulundu. Fokal segmental glomerüloskleroz tespit edilen hastalarda altta yatan ikincil neden olarak monoklonal gamopati düşünülmelidir.
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