Baylor University Medical Center Proceedings January 2014, Volume 27, Number 1 | Page 21

Steroid-resistant nephrotic syndrome secondary to primary
focal segmental glomerulosclerosis and smoldering multiple
myeloma
Rupin Shah, MBBS, Nishi Shah, MBBS, Arun Shah, MD, and Ankit N. Mehta, MD

We present a patient with steroid-resistant nephrotic syndrome due
to focal segmental glomerulosclerosis along with smoldering multiple
myeloma. While investigating the cause of proteinuria, a monoclonal gammopathy with a negative kidney biopsy for myeloma-related
pathology was discovered.

CASE REPORT
A 62-year-old man with systemic hypertension for at least
1 year on amlodipine 5 mg daily presented with frothy urine
for 3 months. He weighed 76 kg, with no recent changes. His
blood pressure was 140/80 mm Hg. Urinalysis disclosed a 4+
proteinuria with no erythrocytes or leucocytes. He ha