Evolution of light chain deposition disease over 8 years.

A 44-year-old female was diagnosed with proteinuria due to nodular glomerulosclerosis secondary to light chain deposition disease (LCDD). After 6 years, deterioration of kidney function occurred and autologous stem cell transplantation was considered, but the patient refused specific therapies. The disease progressed slowly, over a period of 8 years reaching now chronic renal insufficiency stage 4 with a creatinine clearance of 20 ml/min, in spite of no specific therapy. This case, documented by repeated biopsies, demonstrates the very slow loss of kidney function, suggesting the possibility of conservative treatment strategies without taking the risks of chemotherapy or autologous stem cell transplantation, since no long term follow up data of these therapies are available for LCDD.