Systematic review of accuracy of reporting of Congo red-stained amyloid in 2010-2020 compared with earlier.

Background: Almost always, Congo red-stained amyloid between polariser and analyser is said to show "green birefringence" or "apple-green birefringence". In 2010, we found that not all published images showed green, and not all that did showed only green. This systematic review of more recent papers was to find if there had been any improvement in the accuracy of reporting.

Unusual cause of light chain cast nephropathy.

Acute kidney injury due to light chain cast nephropathy is increasingly recognised in patients with haematological malignancies; however, the management and prognosis of this disease remain poorly understood. We describe a case of a 78-year-old woman with known chronic lymphocytic leukaemia (CLL) who presented with fatigue and weight loss. She was found to have acute kidney injury, which rapidly worsened during admission.

Pauci Immune crescentic glomerulonephritis in a patient with T-cell lymphoma and argyria.

Background: Silver is a transition metal, toxic when ingested in significant amounts, causing argyria (skin deposition) and argyrosis (eye deposition). It is excreted mainly via the gastrointestinal tract with only small amounts eliminated by the kidneys, and rarely have cases of nephrotoxicity due to silver been reported. Here we present the case of a woman who used colloidal silver as an alternative remedy for a T cell lymphoma, who subsequently developed argyria and a pauci-immune crescentic glomerulonephritis with evidence of extensive glomerular basement membrane silver deposition.

Value of antibodies to free light chains in immunoperoxidase studies of renal biopsies.

Aims: Because immunoglobulin abnormalities may affect the kidney, investigation of renal biopsies requires immunohistological study of light chains. A problem is that most antibodies to light chains react with whole immunoglobulins as well as free light chains, and there are generally many more whole immunoglobulins than free light chains. The usefulness of antibodies that only detected free light chains was investigated.

Discrepancies between descriptions and illustrations of colours in Congo red-stained amyloid, and explanation of discrepant colours.

Congo red-stained sections of amyloid may show various colours between crossed polariser and analyser. The aims were to see how papers described the colours, to compare descriptions with illustrations, and to explain the colours. In 160 papers on Congo red-stained amyloid, the commonest descriptions were 'green birefringence' and 'apple-green birefringence'.