Table 1.
Laboratory data
| Hemogram and infection |
|---|
| White blood cell 4880/μL (3040–8540) |
| Red blood cell 276 × 104/μL (378–499 × 104) |
| Hemoglobin 8.8 g/dL (10.8–14.9) |
| Hematocrit 27.2% (35.6–45.4) |
| Platelet 12.3 × 104/μL (15.0–36.1 × 104) |
| Hepatitis B virus surface antigen (–) |
| Hepatitis B virus surface antibody ( +) |
| Hepatitis B virus core antibody ( +) |
| Hepatitis B virus—DNA (–) |
| Hepatitis C virus antibody (–) |
| Immunological examinations |
| C-reactive protein 1.97 mg/dL (< 0.3) |
| IgG 283 mg/dL (870–1700) |
| IgA 3218 mg/dL (90–400) |
| IgM 16 mg/dL (35–220) |
| Serum-free light chain κ 13.0 mg/L (3–20) |
| Serum-free light chain λ 9480 mg/L (5–25) |
| Serum-free light chain ratio < 0.01 |
| Complement 3 69 mg/dL (65–135) |
| Complement 4 29 mg/dL (13–35) |
| CH50 41.6 U/mL (28–53) |
| Antinuclear antibody (–) |
| Myeloperoxidase anti-neutrophil cytoplasmic antibody (–) |
| Proteinase 3 anti-neutrophil cytoplasmic antibody (–) |
| C1q immune complex (–) |
| Cryoglobulin (–) |
| Blood chemistry |
| Total protein 8.4 g/dL (6.6–8.0) |
| Albumin 3.3 g/dL (4.1–5.0) |
| BUN 45.0 mg/dL (8–20) |
| sCr 7.92 mg/dL (0.5–0.8) |
| eGFR 6 mg/min/1.73m2 |
| Uric acid 10.2 mg/dL (2.9–5.2) |
| Na 133 mEq/L (138–146) |
| K 4.4 mEq/L (3.6–4.9) |
| Cl 98 mEq/L (99–109) |
| Ca 9.6 mg/dL (8.7–10.0) |
| P 4.5 mg/dL (2.5–4.6) |
| AST 22 IU/L (13–33) |
| ALT 14 IU/L (6–27) |
| LDH 168 IU/L (119–229) |
| ALP 64 IU/L (115–379) |
| Total bilirubin 0.4 mg/dL (0.3–1.2) |
| β2 microglobulin 21.0 mg/L (1–2) |
| Urinalysis |
| Urine protein creatinine ratio 17.04 |
| RBC 1–4/HPF |
| WBC 10–19/HPF |
| Granular casts 1–9/LPF |
| Hyaline casts < 1/LPF |
| Serum immunofixation |
| IgA-λ |
| Urine immunofixation |
| Bence-Jones Protein –λ |
| Bone marrow examination |
| Plasma cells 64% |
| Amyloid deposition (–) |
IgG immunoglobulin G, IgA immunoglobulin A, IgM immunoglobulin M, BUN blood urea nitrogen, sCr serum creatinine, eGFR estimated Glomerular Filtration Rate, Na sodium, K potassium, Cl chloride, Ca calcium, P phosphate, AST aspartate transaminase, ALT alanine transaminase, LDH lactate hydrogenase, ALP alkaline phosphatase