Paraproteinemia and Kidneys – from Henry Bence Jones till Now Days

Urol Nephrol Open Access J 2016, 3(3): 00078 On addition of nitric acid, it effervesces, assumes a reddish hue, and becomes quite clear, but as it cools, assumes the consistency and appearance which you see. Heat reliquifies it. What is it?” Dr Henry Bence Jones tested the urine sample himself and presumed that the substance, defining unusual properties is “deutoxide of albumin”. Now we know that it was not albumin, but free light chains, and can presume that the patient suffered from multiple myeloma with cast nephropathy, which was not yet described at that time. This is in agreement with autopsy findings, revealed by Mr Shaw in January 1846. Autopsy report says: “soft and brittle ribs were noted to the extent that the osseous ribs crumbled under the heel of the scalpel”. No signs of kidney amyloidosis, which was well-recognized by that time as “lardaceous changes”, were found. Dr John Dalrymple, who performed histological examination, noted that mollites ossium was due to replacement of bones by a “gelatin-form substance of a blood red color and unctuous feel” and described nucleated cells which were present in large numbers in the affected bones. Illustrations from his report depict what we now days know as plasma cells.