A case of multiple myeloma presenting with rapidly progressive glomerulonephritis

Multiple myeloma (MM) is a fatal haematological malignancy typically characterized by uncontrolled proliferation of plasma cells in the bone marrow. The characteristic features of MM often include bone pain with lytic lesions discovered on routine skeletal films, symptoms suggestive of anemia, hypercalcaemia and renal insufficiency. Rapidly progressive glomerulonephritis (RPGN) is characterized by features of nephritic syndrome and rapid loss of the kidney function over a short period of time usually within a few weeks to months. Kidney biopsy typically reveals necrotizing and crescentic glomerulonephritis (GN). The most common renal insults observed in MM are cast nephropathy and nephrotic syndrome secondary to glomerular amyloid deposition. RPGN is an uncommon presentation of renal disease in patients MM with only a few cases being reported in the literature. We report a case of 70 year old male who presented to us with features of RPGN and was found to have underlying MM.