REVIEW   

Panminerva Medica 2020 March;62(1):38-53

DOI: 10.23736/S0031-0808.19.03609-7

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Monoclonal gammopathy of renal significance: clinical manifestation, pathogenic characteristic and treatment

Qin CAO ¹, Huimeng QI ², Li YAO ³, Qiang LIU ³ ✉

¹ Department of Gastroenterology, The First Hospital of China Medical University, Shenyang, China; ² Department of General Practice, The First Hospital of China Medical University, Shenyang, China; ³ Department of Nephrology, The First Hospital of China Medical University, Shenyang, China

Monoclonal gammopathy of renal significance (MGRS) is a group of renal disorders caused by a monoclonal immunoglobulin (MIg) secreted by a dangerous plasmatic/B-cell clone hyperplasia through MIg deposition or dysfunction of complement pathway, with increasing risk of progress to end stage renal disease (ESRD) and the underlying hematologic malignancy. The combination of renal biopsy, complete laboratory examination and bone marrow biopsy is an indispensable diagnostic tool for MGRS to identify accurately and unequivocally the pathogenic monoclonal MIg and provide guidance to treatment. Treatment of MGRS is composed of conventional therapy, chemotherapy, and stem cell transplantation to target the underlying clone and eliminate the noxious MIg on the basis of clinical data of some retrospective studies and a small amount of prospective trial. In addition, it is worthwhile point out assessment of therapeutic effect is significantly relevant for renal and overall prognosis. Thus, by comprehensively analyzing the clinical manifestations and pathogenic characteristic of MGRS, early recognition and prompt treatment can improve the prognosis and prevent post-translation recurrence with multidisciplinary cooperation.

KEY WORDS: Drug therapy; Stem cell transplantation; Glomerulonephritis