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• sim. of crystalglobin-associated nephropathy: monoclonal protein–related crystalline nephropathies, light chain proximal tubulopathy, crystalline light chain cast nephropathy, crystal-storing histiocytosis, cryocrystalglobulinemia.

table of all Monoclonal Protein–Related Renal Lesions given.

• mech: crystallization in endoplasmic reticulum, lysosomes (re-uptake), the in capillary lumina as TMA-lookalikes or small-vessel vasculitis. lm: nospecific, subsensitive ihc, eosinophilic material, pronase-digest stains Ig.
• lab: myeloma workup, free light chains, marrow biopsy, albumin-autoantibodies, cryoglobulins.
• treat: independent of myeloma activity chemo, cases bone marrow transplant. heroic plasmapherisis.
• case: rpgn as tma-like lesion, corneal(eye) deposits (img shown)