May 2020 — Renal

39-year-old man who on a routine physical exam was found to have elevated serum creatine at 1.4 mg/dL associated with elevated serum free kappa to lambda ratio at 27. The serum protein electrophoresis (SPEP) test was negative for paraprotein. Urine protein electrophoresis (UPEP) showed a free kappa light chain. Bone marrow biopsy was done and showed 1-2% kappa restricted plasma cells. Additional workup revealed a 24-hour urine protein of 0.5 g, negative fat pad biopsy for amyloid, and negative skeletal survey. A kidney biopsy was performed.

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Sam Albadri, M.B., Ch.B., M.S.
Fellow, Renal Pathology
Mayo Clinic
Photo of Samih H. Nasr, M.D.   Samih Nasr, M.D.
Consultant, Anatomic Pathology
Mayo Clinic
Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine and Science

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