Acquired Fanconi Syndrome with Osteomalacia Secondary to Monoclonal Gammopathy of Undetermined Significance

Toru Hashimoto; Kimika Arakawa; Yuko Ohta; Takaichi Suehiro; Noriko Uesugi; Masaru Nakayama; Takuya Tsuchihashi

doi:10.2169/internalmedicine.46.1882

CASE REPORTS

Acquired Fanconi Syndrome with Osteomalacia Secondary to Monoclonal Gammopathy of Undetermined Significance

Toru Hashimoto, Kimika Arakawa, Yuko Ohta, Takaichi Suehiro, Noriko Uesugi, Masaru Nakayama, Takuya Tsuchihashi

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Keywords: Fanconi syndrome, osteomalacia, Bence Jones protein, monoclonal gammopathy of undetermined significance (MGUS)

JOURNAL OPEN ACCESS

2007 Volume 46 Issue 5 Pages 241-245

DOI https://doi.org/10.2169/internalmedicine.46.1882

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Abstract

A 60-year-old woman was admitted because of multiple bone pain. Examination revealed hypophosphatemic osteomalacia and acquired Fanconi syndrome. Further exploration revealed monoclonal gammopathy of undetermined significance (MGUS) excreting urinary Bence Jones protein (kappa light chain). Renal biopsy showed non-specific tubulointerstitial nephritis, yet neither crystalline inclusions in the cytoplasm of the tubular epithelium nor myeloma casts nor amyloid deposits were found. She was treated with supplementation by phosphate, alkali agents, and vitamin D, and responded well to the treatment symptomatically and biochemically. MGUS was observed without chemotherapy. Myeloma had not developed after 10 months follow-up.

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