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Key Clinical Message: Heavy‐chain deposition disease (HCDD), a rare monoclonal immunoglobulin deposition disease, involves truncated heavy‐chain deposition in kidneys. Limited long‐term data exist. We report a case of renal and cardiac failure with favorable outcomes post bortezomib‐based therapy. Stable renal function observed over 4 years suggests efficacy in HCDD with multisystem involvement. Heavy‐chain deposition disease (HCDD) is an extremely rare form of monoclonal immunoglobulin deposition disease (MIDD) that involves the deposition of truncated immunoglobulin heavy chains in the kidneys. Only a few cases of HCDD with a favorable long‐term renal prognosis have been reported, resulting in limited long‐term follow‐up data for this patient population. In this report, we present the case of a 52‐year‐old patient with nephrotic syndrome who experienced renal failure and cardiac failure. Renal biopsy confirmed the presence of γ3‐HCDD and monoclonal Immunoglobulin G (IgG)κ in the serum. The patient exhibited low voltage on electrocardiogram (ECG) and unexplained left ventricular hypertrophy on cardiac ultrasound. The patient underwent eight cycles of bortezomib‐based chemotherapy, which led to hematological remission. After 4 years of follow‐up, the patient's renal function remained stable, with serum creatinine levels ranging from 0.7 to 0.9 mg/dL and proteinuria of 0.3–0.5 g/24 h. Our findings suggest that bortezomib‐based chemotherapy is equally effective in HCDD patients with combined multisystem damage. [ABSTRACT FROM AUTHOR]

We reported the detection of neural epidermal growth factor-like 1 (NELL-1) and immunoglobulin G4 (IgG4) on glomerular capillary wall in membrane nephropathy (MN), which led to the discovery of early post-operative recurrence of esophageal squamous cell cancer (ESCC) in a 68-year-old man. Further, NELL-1 was also identified in the cancerous tissue sampled by esophagoscope. Moreover, serum IgG4 percentage seemed to be higher when comparing with both previous reports and another age-matched male with NELL-1-negative MN upon fully recovered ESCC. Therefore, the finding of NELL-1 in a renal biopsy should trigger a detailed workup in search of malignancy, especially with concomitant IgG4 dominance. [ABSTRACT FROM AUTHOR]

Diabetic nephropathy (DN) has become one of the major fatal factors in diabetic patients. The aim of this study was to elucidate the function and mechanism by which berberine exerts renoprotective effects in DN. In this work, we first demonstrated that urinary iron concentration, serum ferritin and hepcidin levels were increased and total antioxidant capacity was significantly decreased in DN rats, while these changes could be partially reversed by berberine treatment. Berberine treatment also alleviated DN-induced changes in the expression of proteins involved in iron transport or iron uptake. In addition, berberine treatment also partially blocked the expression of renal fibrosis markers induced by DN, including MMP2, MMP9, TIMP3, β-arrestin-1, and TGF-β1. In conclusion, the results of this study suggest that berberine may exert renoprotective effects by ameliorating iron overload and oxidative stress and reducing DN., (©The Author(s) 2023. Open Access. This article is licensed under a Creative Commons CC-BY International License.)