Abstract
A case of IgG-Bence Jones protein (BJP) κ type multiple myeloma complicated by adult Fanconi syndrome and osteomalacia is reported. A 60-year-old female was admitted to Tsukuba University Hospital in September 1981, because of a back pain. The diagnosis of multiple myeloma was made on the basis of Bence Jones κ proteinuria, IgG (κ) paraprotein and BJP (κ) on serum immunoelectrophoresis and plasmocytosis in the bone marrow (14.4%). The plasma cells were found to have vacuole-like and granular structure in the cytoplasm, in which filament-like structures of various density were identified by electron microscopy. Analyses of serum and urine appeared hypouricemia, hypophosphatemia, hypokalemia, glycosuria, proteinuria and panaminoaciduria. Results of creatinine clearance, phosphate clearance and uric acid clearance showed renal dysfunction predominantly in proximal tubules. X-ray study revealed multiple bone fractures. Osteomalacia was found by iliac bone biopsy. These findings were interpreted that IgG-BJP (κ) type multiple myeloma was complicated by adult Fanconi syndrome as well as osteomalacia. We reviewed literatures and discussed about adult Fanconi syndrome and osteomalacia complicated to multiple myeloma.
