case_images: PMC6375021_01
case_images: (a) Low magnification photomicrograph showing myeloma casts, focal acute tubular injury, and the presence fine vacuoles in the tubular epithelium (representing tubulopathy). No crystalline inclusions seen (H and E, x100). (b) Myeloma cast surrounded by giant cell (PAS, x400)
case_images: IJN-29-65-g001.jpg
case_images: PMC6375021_01_IJN-29-65-g001.jpg
case_images: F1
case_images: We advised for a repeat graft biopsy, which showed evidence of MCN [Figure 1] with lambda (lambda) light chain restriction [Figure 2] and proximal tubulopathy [Figure 3].
case_images: Direct immunofluorescence showing lambda restricted cast nephropathy (a: Anti-lambda, b: Anti-kappa, FITC tagged)
case_images: IJN-29-65-g002.jpg
case_images: PMC6375021_01_IJN-29-65-g002.jpg
case_images: F2
case_images: We advised for a repeat graft biopsy, which showed evidence of MCN [Figure 1] with lambda (lambda) light chain restriction [Figure 2] and proximal tubulopathy [Figure 3].
case_images: Direct immunofluorescence showing lambda restricted proximal tubulopathy (a: Anti-lambda, b: Anti-kappa, FITC tagged)
case_images: IJN-29-65-g003.jpg
case_images: PMC6375021_01_IJN-29-65-g003.jpg
case_images: F3
case_images: We advised for a repeat graft biopsy, which showed evidence of MCN [Figure 1] with lambda (lambda) light chain restriction [Figure 2] and proximal tubulopathy [Figure 3].