Renal involvement is a frequent consequence of plasma cell dyscrasias. The most common entities are light chain amyloidosis, monoclonal immunoglobulin deposition disease and myeloma cast nephropathy. Despite a common origin, each condition has its own unique histologic and pathophysiologic characteristic which requires a renal biopsy to distinguish. Recent studies have shown urinary exosomes co...

BACKGROUND Autoimmune polyglandular syndrome type 2 represents an uncommon endocrine disorder composed by Addison's disease with autoimmune thyroid disease (Schmidt's syndrome) and/or type 1 diabetes mellitus. Scleromyxedema is a rare progressive cutaneous mucinosis usually associated with systemic involvement and paraproteinemia. To the best of our knowledge, there is no case report of Schmidt...

Hypophosphatemia is a relatively uncommon finding in clinical practice, with a prevalence of 1–5% in all hospitalized patients. However, it is an adverse prognostic marker for mortality and morbidity. Although the correlation between serum phosphate levels and symptoms is not linear, severe hypophosphatemia is important to recognize and treat since it can lead to rhabdomyolysis, haemolysis, res...

Nephrogenic systemic fibrosis (NSF), previously known as nephrogenic fibrosing dermopathy, is an emerging systemic fibrosing disorder that develops in the setting of renal insufficiency. Nephrogenic fibrosing dermopathy (NFD) is a fibrosing condition of the skin which shows an increased number of dendritic cells, fibroblasts and thickened collagen fibers resembling scleromyxedema. It is charact...

The IgM in three patients with paraproteinemia and peripheral neuropathy was shown to bind to human myelin-associated glycoprotein (MAG) that had been purified to homogeneity by gel filtration on Sepharose CL-6B. The antigenic determinant reacting with the IgM from all three patients was in the carbohydrate part of the MAG molecule. In addition, the IgM from the same three patients bound to a s...

Pseudohyponatremia is caused by an increased serum protein or lipid concentration producing a "space-occupying lesion" in serum water. Its presence and magnitude must be assessed in hyponatremic patients with, for example, paraproteinemia or hyperlipemic diabetic coma. In the absence of a direct-reading ion-selective electrode system, a method for measuring the water content of serum is require...

Scleromyxedema is a rare chronic cutaneous mucinosis of unknown etiology. It is characterized by papular eruption and scleroderma with microscopic evidence of mucin deposition, fibroblast proliferation, and fibrosis. Most patients with scleromyxedema have monoclonal gammopathy and systemic manifestations resulting in significant morbidity and mortality. Several types of treatment have been repo...