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Acute renal failure following intravenous pyelography (IVP) in a patient with diffuse hypergammaglobulinemia: A case report

✍ Scribed by Antman, Karen Hamm ;Parker, Leroy M. ;Goldstein, Jeffrey D. ;Skarin, Arthur T. ;D'Orsi, Carl J.

Publisher: John Wiley and Sons
Year: 1982
Tongue: English
Weight: 667 KB
Volume: 10
Category: Article
ISSN: 0098-1532
DOI: 10.1002/mpo.2950100310

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✦ Synopsis

Abstract

A 65‐year‐old woman with polyclonal hypergammaglobulinemia developed acute renal failure requiring hemodialysis after an intravenous pyelogram (IVP). An increased risk of renal injury after IVP for patients with polyclonal hypergammaglobulinemia has not been previously recognized, although a parallel risk to patients with myeloma has been well established. At autopsy, immunoperoxidase staining of the bone marrow demonstrated plasma cell subpopulations with intracellular staining for IgG, IgA, and IgM and χ and λ light chains, proving that this patient did not have occult myeloma. Immunoperoxidase staining of casts in renal tubules also demonstrated polyclonal immunoglobulins.

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