Monoclonal Gammopathy of Renal Significance: Histomorphological Spectrum at a Tertiary Care Center
| Autor: | Adarsh Barwad, Varun Bajaj, Geetika Singh, Amit Kumar Dinda, Ranjit Kumar Sahoo, Lalit Kumar, Sanjay Kumar Agarwal |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
monoclonal gammopathy
al amyloidosis light chain deposition disease heavy chain deposition disease fibrillary glomerulonephritis immunotactoid glomerulonephritis light chain proximal tubulopathy proliferative glomerulonephritis with monoclonal immune deposits Diseases of the endocrine glands. Clinical endocrinology RC648-665 |
| Zdroj: | Glomerular Diseases (2022) |
| Druh dokumentu: | article |
| ISSN: | 2673-3633 |
| DOI: | 10.1159/000526244 |
| Popis: | Introduction: The term monoclonal gammopathy of renal significance (MGRS) has been described to include patients with renal manifestations associated with circulating monoclonal proteins with or without a clonal lymphoproliferation (B-cell or plasma cell) and not meeting diagnostic criteria for an overt hematological malignancy. A host of MGRS-associated lesions have been described that involve various renal compartments. Our study describes the histomorphological spectrum of MGRS cases at our center in the last 5 years and description as per the classification system of the International Kidney and Monoclonal Gammopathy Research Group (IKMG). Material and Methods: Retrospective analysis was carried out of all the renal biopsies with characteristic monoclonal immunoglobulin lesions for histopathological diagnosis between years 2015 and 2020 and reviewed by two independent pathologists. Results: Most patients in the study belonged to the fifth decade, with a median age of 50 years (mean 50.14 ± 10.43) range (24–68 years) with a male preponderance. Most patients presented with proteinuria as the sole manifestation (66.6%). Many of the patients (48%) had an M spike by serum protein electrophoresis or urinary protein electrophoresis with an abnormal serum free light chain assay (60.8%). AL amyloidosis was the most common diagnosis observed on histopathological evaluation (68.7%), followed by light chain deposition disease (10.4%). Conclusion: MGRS lesions are infrequently encountered in the practice of nephropathology and pose a diagnostic challenge due to the limitation of a congruent clinical or hematological picture. A thorough histological examination with immunofluorescence and electron microscopy often precipitates in the right diagnosis and prompts timely management. |
| Databáze: | Directory of Open Access Journals |
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