Purpose: Light- and heavy-chain deposition disease (LHCDD) is a rare form of nonamyloidal monoclonal immunoglobulin deposition disease (MIDD) in which light- and heavy-chain immunoglobulin fragments accumulate systemically, typically leading to end organ dysfunction. Herein we describe the case of a 64-year-old female with a history of Graves' orbitopathy and multiple myeloma who presented with bilateral asymmetric compressive optic neuropathies.
Procedure: A biopsy of the right medial rectus muscle was taken during orbital decompression surgery.
Results: Light and electron microscopy of the biopsy specimen led to a diagnosis of intracellular skeletal muscle LHCDD.
Conclusion: This is the first published report to describe the findings of: (1) intracellular deposition of nonamyloidal MIDD; (2) orbital involvement of nonamyloidal MIDD, and (3) compressive optic neuropathy resulting from any form of MIDD.
(c) 2009 S. Karger AG, Basel.