Dandan Liang1, Jing Liu2, Shaoshan Liang2, Feng Xu2, Zhen Cheng2, Xianghua Huang2, Caihong Zeng2, Zhihong Liu3,4. 1. National Clinical Research Center of Kidney Diseases, Jinling Clinical Medical College of Nanjing Medical University, 305 East Zhongshan Road, Nanjing, China. 2. National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China. 3. National Clinical Research Center of Kidney Diseases, Jinling Clinical Medical College of Nanjing Medical University, 305 East Zhongshan Road, Nanjing, China. liuzhihong@nju.edu.cn. 4. National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China. liuzhihong@nju.edu.cn.
Abstract
BACKGROUND: The development of renal disease in patients with monoclonal gammopathy of renal significance (MGRS) depends on the pathogenicity of the secreted monoclonal protein (M protein). However, the correlation between the types of M proteins and clinical and renal pathological features is still unclear. METHODS: A total of 148 patients with detectable serum M protein and biopsy-proven MGRS were recruited. The patients were categorized according to the heavy and light chain types of M protein in the serum. RESULTS: Among 148 patients, the most common M protein was IgGλ, followed by IgAλ and IgGκ. According to the type of heavy chain, patients with IgM-MGRS were more likely to have renal dysfunction, anemia and hypocomplementemia than patients with IgG-MGRS and IgA-MGRS. The λ light chain was predominant in patients with IgG-MGRS and IgA-MGRS, whereas the κ light chain was predominant in patients with IgM-MGRS. The most common renal lesion was amyloidosis in patients with IgG-MGRS and IgA-MGRS, while it was cryoglobulinemic glomerulonephritis in patients with IgM-MGRS. According to the type of light chain, patients with κ light chain were more likely to be male and to have renal dysfunction, anemia and hypocomplementemia than those with λ light chain. The types of heavy chain and light chain of M protein were not associated with patient or renal survival. CONCLUSION: The clinicopathological features were distinct in patients with different types of M protein. Integration of the types of M protein and renal pathologic findings may shed light on individual management of patients with MGRS.
BACKGROUND: The development of renal disease in patients with monoclonal gammopathy of renal significance (MGRS) depends on the pathogenicity of the secreted monoclonal protein (M protein). However, the correlation between the types of M proteins and clinical and renal pathological features is still unclear. METHODS: A total of 148 patients with detectable serum M protein and biopsy-proven MGRS were recruited. The patients were categorized according to the heavy and light chain types of M protein in the serum. RESULTS: Among 148 patients, the most common M protein was IgGλ, followed by IgAλ and IgGκ. According to the type of heavy chain, patients with IgM-MGRS were more likely to have renal dysfunction, anemia and hypocomplementemia than patients with IgG-MGRS and IgA-MGRS. The λ light chain was predominant in patients with IgG-MGRS and IgA-MGRS, whereas the κ light chain was predominant in patients with IgM-MGRS. The most common renal lesion was amyloidosis in patients with IgG-MGRS and IgA-MGRS, while it was cryoglobulinemic glomerulonephritis in patients with IgM-MGRS. According to the type of light chain, patients with κ light chain were more likely to be male and to have renal dysfunction, anemia and hypocomplementemia than those with λ light chain. The types of heavy chain and light chain of M protein were not associated with patient or renal survival. CONCLUSION: The clinicopathological features were distinct in patients with different types of M protein. Integration of the types of M protein and renal pathologic findings may shed light on individual management of patients with MGRS.
Entities:
Keywords:
Monoclonal gammopathy of renal significance; Monoclonal protein; Renal pathology