Updates in Plasma Cell Dyscrasias and Related Monoclonal Immunoglobulin-Mediated Renal Disease

IF 2.8 3区医学 Q2 UROLOGY & NEPHROLOGY

Seminars in nephrology Pub Date : 2022-11-01 DOI:10.1016/j.semnephrol.2023.151352

Shonali Midha MD , Omar Nadeem MD , Umut Selamet MD

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引用次数: 0

Abstract

Pathogenic roles of monoclonal immunoglobulins in kidney disease have been attributed previously to malignant plasma cell and lymphoproliferative disorders such as multiple myeloma, lymphoplasmacytic lymphoma, chronic lymphocytic leukemia, or amyloid light chain amyloidosis. Improved technology, advancements in molecular diagnostics, and highly sensitive imaging techniques have established the need to redefine monoclonal gammopathies and the kidney disorders that are associated with monoclonal immunoglobulins regardless of tumor burden. This has led to the establishment of monoclonal gammopathy with renal significance (MGRS). MGRS was defined by the International Kidney and Monoclonal Gammopathy Research Group in 2012 as a clonal proliferative disorder that produces a nephrotoxic monoclonal immunoglobulin and does not meet previously defined hematological criteria for treatment of a specific malignancy. MGRS encompasses a wide array of pathologies with knowledge surrounding its incidence, prognosis, and management continuously increasing. This review examines the current evidence on the diagnosis, prognosis, pathogenesis, and therapy of plasma cell dyscrasias and related MGRS.

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浆细胞异常和相关单克隆免疫球蛋白介导的肾脏疾病的最新进展

单克隆免疫球蛋白在肾脏疾病中的致病作用先前被归因于恶性浆细胞和淋巴增生性疾病，如多发性骨髓瘤、淋巴浆细胞性淋巴瘤、慢性淋巴细胞白血病或淀粉样蛋白轻链淀粉样变性。技术的改进、分子诊断的进步和高灵敏度成像技术已经确立了重新定义与单克隆免疫球蛋白相关的单克隆伽玛病和肾脏疾病的必要性，而不管肿瘤负荷如何。这导致了具有肾脏意义的单克隆γ病(MGRS)的建立。MGRS于2012年被国际肾脏和单克隆伽玛病研究小组定义为一种克隆增殖性疾病，产生肾毒性单克隆免疫球蛋白，并且不符合先前定义的治疗特定恶性肿瘤的血液学标准。MGRS包括一系列广泛的病理，其发病率、预后和管理方面的知识不断增加。本文综述了浆细胞异常及相关核磁共振成像的诊断、预后、发病机制和治疗的最新证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in nephrology 医学-泌尿学与肾脏学

CiteScore

5.60

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Seminars in Nephrology is a timely source for the publication of new concepts and research findings relevant to the clinical practice of nephrology. Each issue is an organized compendium of practical information that serves as a lasting reference for nephrologists, internists and physicians in training.