[Paraprotein-related kidney disease. Experience in 22 cases].
Nefropatías secundarias a paraproteína: perfil clínico a partir de hallazgos histológicos.
Journal
Revista medica de Chile
ISSN: 0717-6163
Titre abrégé: Rev Med Chil
Pays: Chile
ID NLM: 0404312
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
24
04
2020
accepted:
03
09
2020
entrez:
5
1
2021
pubmed:
6
1
2021
medline:
26
1
2021
Statut:
ppublish
Résumé
One of the devastating consequences of monoclonal gammopathies is the development of end-stage kidney disease, which can be prevented with an early diagnosis. Renal involvement can be secondary to saturation of paraproteins with intratubular precipitation or the glomerular deposition of paraproteins with secondary inflammation and destruction. These conditions can also be associated with monoclonal gammopathies that do not meet hematological treatment criteria, called monoclonal gammopathies of renal significance (MGRS). To report a retrospective analysis of patients who underwent a renal biopsy and whose final diagnosis was a form of monoclonal gammopathy. We reviewed the clinical and laboratory features and response to treatment of 22 patients aged 63 ± 12 years (55% women) with a pathological diagnosis of a nephropathy associated with paraproteinemia. The most common hematological diagnosis was amyloidosis in 50% of patients, followed by cast nephropathy. The predominant clinical presentations were proteinuria (without nephrotic syndrome) and nephritic syndrome. Classic criteria such as erythrocyte sedimentation rate > 100 mm/h and protein-albumin gap were unusual. Serum light chain quantification was the test with the best yield to detect paraproteins. In this group of patients, light chains tend to affect the kidney more commonly than heavy chains. The prognosis of multiple myeloma is much worse than MGRS.
Sections du résumé
BACKGROUND
BACKGROUND
One of the devastating consequences of monoclonal gammopathies is the development of end-stage kidney disease, which can be prevented with an early diagnosis. Renal involvement can be secondary to saturation of paraproteins with intratubular precipitation or the glomerular deposition of paraproteins with secondary inflammation and destruction. These conditions can also be associated with monoclonal gammopathies that do not meet hematological treatment criteria, called monoclonal gammopathies of renal significance (MGRS).
AIM
OBJECTIVE
To report a retrospective analysis of patients who underwent a renal biopsy and whose final diagnosis was a form of monoclonal gammopathy.
MATERIAL AND METHODS
METHODS
We reviewed the clinical and laboratory features and response to treatment of 22 patients aged 63 ± 12 years (55% women) with a pathological diagnosis of a nephropathy associated with paraproteinemia.
RESULTS
RESULTS
The most common hematological diagnosis was amyloidosis in 50% of patients, followed by cast nephropathy. The predominant clinical presentations were proteinuria (without nephrotic syndrome) and nephritic syndrome. Classic criteria such as erythrocyte sedimentation rate > 100 mm/h and protein-albumin gap were unusual. Serum light chain quantification was the test with the best yield to detect paraproteins.
CONCLUSIONS
CONCLUSIONS
In this group of patients, light chains tend to affect the kidney more commonly than heavy chains. The prognosis of multiple myeloma is much worse than MGRS.
Identifiants
pubmed: 33399771
pii: S0034-98872020000801059
doi: 10.4067/S0034-98872020000801059
pii:
doi:
Substances chimiques
Paraproteins
0
Types de publication
Journal Article
Langues
spa
Sous-ensembles de citation
IM