Case 47 – update 2

So we have another update on our gentleman.
He has been found to have nephrotic syndrome and a renal biopsy has been performed which has now come back and is consistent with AL Amyloid nephropathy.
Further investigations revealed an IgG lambda paraprotein of 7g/l with lambda light chains in the urine and serum free light chain which have shown kappa 13 mg/l and lambda of 1020mg/l.
A clotting screen has been done which shows pt 13, aptt 33, fib 4.0
We have been ask for a bone marrow and the results of the marrow should be available later today!
What is the diagnosis? How would you treat this gentleman? Are there any other things which you need to consider? Any other investigations you would like?
Remember to use #teamhaem on all your posts to help us follow the case! Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality. TeamHaem are not a position of authority. It is an educational platform to allow discussion and learning.

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Online education and discussion about all things haematological
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