Document Detail


Membranoproliferative glomerulonephritis secondary to monoclonal gammopathy.
MedLine Citation:
PMID:  20185597     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Sanjeev Sethi; Ladan Zand; Nelson Leung; Richard J H Smith; Dragan Jevremonic; Sandra S Herrmann; Fernando C Fervenza
Related Documents :
20205317 - Acquired reactive perforating collagenosis: a clinicopathologic study of 15 cases from ...
9594257 - Immunofluorescence study of type iv collagen alpha chains in epidermal basement membran...
19154497 - Hybrid tumour 'oncocytoma-chromophobe renal cell carcinoma' of the kidney: a report of ...
3530107 - Significant correlation between the immunofluorescence of alpha 2-plasmin inhibitor in ...
15587317 - The prevalence of portal hypertensive gastropathy and duodenopathy in some egyptian cir...
3147127 - Determinants of urinary nitrogen excretion in burned patients.
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    
Affiliation:
Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA. sethi.sanjeev@mayo.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antibodies, Monoclonal / blood,  urine
Biopsy
Blood Protein Electrophoresis
Bone Marrow / immunology,  pathology
Bone Marrow Examination
Female
Fluorescent Antibody Technique
Glomerulonephritis, Membranoproliferative / immunology*,  pathology,  therapy
Humans
Kidney / immunology*,  pathology
Male
Middle Aged
Paraproteinemias / complications,  immunology*,  pathology,  therapy
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
DK074409/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Reducing polycystic liver volume in ADPKD: effects of somatostatin analogue octreotide.
Next Document:  Randomized trial of model predictive control for improved anemia management.