Document Detail

Membranoproliferative glomerulonephritis secondary to monoclonal gammopathy.
MedLine Citation:
PMID:  20185597     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: Membranoproliferative glomerulonephritis (MPGN) is an immune complex-mediated glomerulonephritis characterized by subendothelial and mesangial deposition of immune complexes. Autoimmune diseases and chronic infections, such as hepatitis C, are commonly recognized causes of MPGN; however, monoclonal gammopathy is a less widely recognized cause of MPGN.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We reviewed all renal biopsies of MPGN in Mayo Clinic patients during a 6-year period to determine the association of monoclonal gammopathy with MPGN. Results were correlated with electrophoresis studies and bone marrow biopsies to clarify the relationship between MPGN and gammopathies.
RESULTS: Of 126 patients with MPGN, 20 did not have workup for hepatitis B or C. Of the remaining 106 patients, 25 (23.5%) were positive for hepatitis B or C. Of the 81 hepatitis-negative patients, 13 were not evaluated for gammopathies. Of the remaining 68 patients, 28 (41.1%) had serum and/or urine electrophoresis studies positive for monoclonal gammopathy. Serum immunofixation electrophoresis was the most sensitive method for diagnosing monoclonal gammopathy. Renal biopsy showed a membranoproliferative pattern of injury; immunofluorescence microscopy was often instrumental in diagnosing the underlying gammopathy. On the basis of the bone marrow biopsy, monoclonal gammopathy of undetermined significance was the most common entity associated with MPGN. Other, less common causes included multiple myeloma, low-grade B cell lymphoma, and chronic lymphocytic leukemia.
CONCLUSIONS: Monoclonal gammopathy is an important and common cause of MPGN; therefore, all patients with a diagnosis of MPGN should be evaluated for an underlying monoclonal gammopathy.
Sanjeev Sethi; Ladan Zand; Nelson Leung; Richard J H Smith; Dragan Jevremonic; Sandra S Herrmann; Fernando C Fervenza
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-02-25
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  5     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-08-12     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  770-82     Citation Subset:  IM    
Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.
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MeSH Terms
Aged, 80 and over
Antibodies, Monoclonal / blood,  urine
Blood Protein Electrophoresis
Bone Marrow / immunology,  pathology
Bone Marrow Examination
Fluorescent Antibody Technique
Glomerulonephritis, Membranoproliferative / immunology*,  pathology,  therapy
Kidney / immunology*,  pathology
Middle Aged
Paraproteinemias / complications,  immunology*,  pathology,  therapy
Time Factors
Treatment Outcome
Grant Support
Reg. No./Substance:
0/Antibodies, Monoclonal

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