Monoclonal gammopathy of renal significance: Early diagnosis is key |
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Institution: | 1. Nephrology Department, Carlos Haya Regional University Hospital and University of Malaga, IBIMA, REDinREN (RD16/0009/0006), Malaga, Spain;2. Pathology Department, Carlos Haya Regional University Hospital, Malaga, Spain |
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Abstract: | Monoclonal gammopathy of renal significance is a clinical–pathological entity grouping renal disorders secondary to the secretion of a monoclonal immunoglobulin synthesized by a B-cell-derived clone and/or plasma cells in a patient with no diagnostic criteria for multiple myeloma. This term applies to a concept recently introduced owing to the need to differentiate this entity from monoclonal gammopathy of undetermined significance, given the negative prognostic impact of its high morbidity and mortality resulting from both renal and systemic involvement, occasionally even progressing to advanced chronic kidney disease. The renal damage occurs via both direct pathogenic mechanisms, with the deposition of the monoclonal protein in different renal structures, as well as indirect mechanisms, acting as an autoantibody provoking dysregulation of the alternative complement pathway. The detection of this monoclonal protein and an early hematologic study are essential, as is the need for a kidney biopsy to establish the associated nephropathological diagnosis. Consequently, this then leads to the start of specific hematologic treatment to detain the production of the monoclonal protein and minimize renal and systemic injury. |
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Keywords: | Monoclonal gammopathy of renal significance Monoclonal gammopathy of uncertain significance Monoclonal gammopathy Multiple myeloma Monoclonal immunoglobulin deposition disease Membranoproliferative glomerulonephritis with monoclonal immunoglobulin deposits Free light chain Gammapatía monoclonal de significado renal Gammapatía monoclonal de significado incierto Gammapatía monoclonal Mieloma múltiple Enfermedad por depósito de inmunoglobulina monoclonal Glomerulonefritis membranoproliferativa con depósitos de inmunoglobulinas monoclonales Cadena ligera libre |
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