Thrombotic microangiopathy (TMA) associated with multiple myeloma is a rare but serious condition involving complex mechanisms including endothelial light chain toxicity, complement activation, and iatrogenic factors. We report the case of a 44-year-old woman with severe renal failure revealing multiple myeloma, complicated by histologically confirmed TMA. The absence of prior treatment suggests a direct role of monoclonal gammopathy. Initial management resulted in partial improvement of renal function. A review of the literature highlights the importance of early diagnosis based on renal biopsy. Treatment focuses on controlling the myeloma and, in some cases, on complement-targeted therapies.
Congera et al. (Thu,) studied this question.
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