肾性IgM单克隆γ病（MGRS）进展为症状性Waldenström巨球蛋白血症：1例报告

IF 1.9 Q4 ONCOLOGY

Cancer reports Pub Date : 2025-07-19 DOI:10.1002/cnr2.70281

Kenichi Ito, Hiroaki Shimoyamada, Kazuhiko Hirano, Naohiro Sekiguchi

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引用次数: 0

摘要

背景肾重要性单克隆伽玛病（MGRS）的特征是单克隆蛋白引起的肾脏损害，但不符合特定血液系统恶性肿瘤的标准。大多数MGRS病例涉及IgG、IgA或轻链，但IgM-MGRS仍然知之甚少。我们报告了一位74岁的女性，患有IgM-κ单克隆蛋白尿，最初拒绝进一步评估。后来，贫血被确诊，系统检查显示肾脏单克隆免疫球蛋白沉积病和症状性Waldenström巨球蛋白血症。布鲁顿酪氨酸激酶抑制剂，即替拉替尼治疗，迅速解决蛋白尿和贫血。结论本病例强调早期肾活检和及时干预对疑似IgM-MGRS的重要性。

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Progression of IgM Monoclonal Gammopathy of Renal Significance (MGRS) to Symptomatic Waldenström Macroglobulinemia: A Case Report

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Progression of IgM Monoclonal Gammopathy of Renal Significance (MGRS) to Symptomatic Waldenström Macroglobulinemia: A Case Report

Background

Monoclonal gammopathy of renal significance (MGRS) is characterized as renal impairment caused by monoclonal protein but does not fulfill the criteria for specific hematologic malignancies. Most MGRS cases involve IgG, IgA, or light chains, but IgM-MGRS remains poorly understood.

Case

We present a 74-year-old woman with IgM-κ monoclonal proteinuria who initially declined further evaluation. Later, anemia was identified, and a systemic work-up revealed monoclonal immunoglobulin deposition disease in the kidney and symptomatic Waldenström macroglobulinemia. Treatment with a Bruton's tyrosine kinase inhibitor, namely tirabrutinib, rapidly resolved both proteinuria and anemia.