A History of the Kidney in Plasma Cell Disorders

Steensma, David P.; Kyle, Robert A.

doi:10.1159/000096757

Cited by 18 publications

(10 citation statements)

References 56 publications

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“…Several reports have noted that DRA is related to the duration of HD and can be cured by kidney transplantation. 1,7,12) In this case, the amorphous amyloid materials infiltrated not only into the extensor and flexor tendons but also into the wrist joint. In the operation, clear identification and separation of amyloid body from the tendon was very difficult.…”

Section: Discussionmentioning

confidence: 79%

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Severe Destructive Tendinopathy in the Wrist Due to Dialysis-Related Amyloidosis

Kim

Choi²,

Park

2017

J Hand Surg Asian-Pac Vol

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Dialysis-related amyloidosis (DRA) is a specific subtype of amyloidosis with several clinical presentations. Herein we report a case of severe destructive tendinopathy around the wrist associated with long-standing hemodialysis (HD). A 63-year-old female patient who had been on regular HD for 23 years suffered from symptoms of pain and a palpable mass around the wrist. Magnetic resonance imaging showed an ill-defined soft tissue mass around the extensor tendons that partially invaded the wrist joint. We performed surgical excision and tenolysis for the mass. The operative finding revealed an ill-defined yellowish soft tissue mass extensively invading the extensor tendons and wrist joint. The tendon fibers were severely fibrillated and showed impending rupture due to the infiltrated mass. Histological examination showed DRA. Amyloidosis-induced tendinopathy should be considered when a patient on long-term HD complains of an unusual mass-like lesion in the extremity and/or nonspecific joint stiffness. Early surgical intervention improves patient’s disability and decreases the risk of spontaneous tendon rupture.

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Section: Discussionmentioning

confidence: 79%

“…The term "amyloid" was first used by the pathologist Rudolf Virchow, who described such deposits as comprising cellulose-like material. 1) Meanwhile, dialysis-related amyloidosis (DRA), also known as β-2 microglobulin amyloidosis, is a specific subtype of amyloidosis that is commonly seen in endstage renal disease.…”

Section: Introductionmentioning

confidence: 99%

Severe Destructive Tendinopathy in the Wrist Due to Dialysis-Related Amyloidosis

Kim

Choi²,

Park

2017

J Hand Surg Asian-Pac Vol

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“…The species of Aspergillus that cause invasive infection are limited, but these share an important trait: the ability to grow at 37°C, human body temperature. Among those that cause invasive disease in humans, A. fumigatus is the most prevalent followed, by A. flavus (1,2). Despite constant contact with conidia, the immunocompetent host rarely develops invasive disease, largely because immune defenses in lungs are highly effective.…”

Section: Nadph Oxidase Regulates Efficacy Of Vaccination In Aspergillmentioning

confidence: 99%

“…Chief among them are the use of glucocorticoids to treat inflammatory disorders, severe neutropenia induced by cytotoxic agents, or, less frequently, the use of TNF-a antagonists. The risk of disease acquisition escalates in parallel with the length of glucocorticoid administration or the duration of neutropenia (1). Qualitative defects in neutrophil function also increase the probability of acquiring disease.…”

Section: Nadph Oxidase Regulates Efficacy Of Vaccination In Aspergillmentioning

confidence: 99%

Treating myeloma cast nephropathy without treating myeloma

Leung

2012

J. Clin. Invest.

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“…In honor of his work, the M-LC was later named the Bence Jones protein (BJP). Advances in electrophoresis technique allowed for the separation of serum proteins into three major bands, α, β, and γ [4]. In 1956, Korngold and Lipari demonstrated that the BJP actually contained two antigenic separate types of 7-S globulin which were later named κ and λ in their honor [5].…”

Section: Introductionmentioning

confidence: 99%

Laboratory testing in monoclonal gammopathy of renal significance (MGRS)

Leung

Barnidge

Hutchison³

2016

Clinical Chemistry and Laboratory Medicine (CCLM)

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Abstract:Recently, monoclonal gammopathy of renal significance (MGRS) reclassified all monoclonal (M) gammopathies that are associated with the development of a kidney disease but do not meet the definition of symptomatic multiple myeloma (MM) or malignant lymphoma. The purpose was to distinguish the M gammopathy as the nephrotoxic agent independent from the clonal mass. The diagnosis of MGRS obviously depends on the detection of the M-protein. More importantly, the success of treatment is correlated with the reduction of the M-protein. Therefore, familiarity with the M-protein tests is a must. Protein electrophoresis performed in serum or urine is inexpensive and rapid due to automation. However, poor sensitivity especially with the urine is an issue particularly with the low-level M gammopathy often encountered with MGRS. Immunofixation adds to the sensitivity and specificity but also the cost. Serum free light chain (sFLC) assays have significantly increased the sensitivity of M-protein detection and is relatively inexpensive. It is important to recognize that there is more than one assay on the market and their results are not interchangeable. In addition, in certain diseases, immunofixation is more sensitive than sFLC. Finally, novel techniques with promising results are adding to the ability to identify M-proteins. Using the time of flight method, the use of mass spectrometry of serum samples has been shown to dramatically increase the sensitivity of M-protein detection. In another technique, oligomeric LCs are identified on urinary exosomes amplifying the specificity for the nephrotoxic M-protein.

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A History of the Kidney in Plasma Cell Disorders

Abstract: Historical understanding of the kidney in plasma cell disorders reflects developments in understanding of the anatomy and physiology of the kidneys in health and in disease.

Cited by 18 publications

References 56 publications

Severe Destructive Tendinopathy in the Wrist Due to Dialysis-Related Amyloidosis

Severe Destructive Tendinopathy in the Wrist Due to Dialysis-Related Amyloidosis

Treating myeloma cast nephropathy without treating myeloma

Laboratory testing in monoclonal gammopathy of renal significance (MGRS)

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