Southwestern Internal Medicine Conference: Plasma Cell Dyscrasias and the Kidney

Seney, Frank D.; Silva, Fred G.

doi:10.1097/00000441-198706000-00012

Cited by 4 publications

(1 citation statement)

References 89 publications

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“…An association between monoclonal IgA gammopathy and IgA nephropathy is rare but has been noted before, in at least 3 of the thousands of patients thus far reported with IgA nephropathy [35][36][37][38][39], Although this combina tion is exceedingly unusual and of uncertain pathophys iologic significance, it would seem prudent to consider serum immunoelectrophoresis in approaching the older patient with IgA nephropathy. Rifai et al [40] have shown that injection of myeloma IgA proteins can pro duce an experimental model of IgA nephropathy.…”

Section: Discussionmentioning

confidence: 99%

Mesangial Immunoglobulin A Deposits in Minimal Change Nephrotic Syndrome: A Report of an Older Patient and Review of the Literature

Clive¹,

Galvanek²,

Silva³

1990

Am J Nephrol

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A 57-year-old patient with a history of monoclonal immunoglobulin A (IgA) gammopathy developed idiopathic nephrotic syndrome. Renal biopsy showed minimal glomerular changes with predominant glomerular mesangial IgA. The association of glomerular mesangial IgA with otherwise typical minimal change nephrotic syndrome has been noted before, and the literature concerning this combination of findings is reviewed. The patient herein described represents one of the two oldest patients yet reported with this syndrome and raises questions about the relationship between minimal change disease and IgA nephropathy. Severe proteinuria (and even the nephrotic syndrome) is not necessarily the harbinger of a poor prognosis in IgA nephropathy if the glomerular morphology is otherwise consistent with minimal change nephrotic syndrome. Such patients should be treated in a fashion similar to those with minimal change nephrotic syndrome. The significance of the IgA gammopathy in the pathogenesis of this case is unknown.

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Section: Discussionmentioning

confidence: 99%

Mesangial Immunoglobulin A Deposits in Minimal Change Nephrotic Syndrome: A Report of an Older Patient and Review of the Literature

Clive¹,

Galvanek²,

Silva³

1990

Am J Nephrol

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Kidney in multiple myeloma and related disorders

Kyle

1988

The Kidney in Plasma Cell Dyscrasias

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Monoclonal Gammopathies and the Kidney

Kyle¹

1989

Annu. Rev. Med.

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The major causes of renal insufficiency, present initially in half of the patients with multiple myeloma, are "myeloma kidney" and hypercalcemia. There is no reliable evidence that the isoelectric point (pI) or the type of light chain has an important role in renal failure. Acute renal failure must be treated vigorously with appropriate fluids and electrolytes as well as hemodialysis if necessary. The benefit of plasma exchange has not been proven. Primary systemic amyloidosis or light-chain deposition disease is the usual cause of the nephrotic syndrome in patients with monoclonal gammopathy. The monoclonal gammopathies are a group of disorders that are characterized by the proliferation of plasma cells producing a homogeneous, monoclonal protein (M-protein).

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Southwestern Internal Medicine Conference: Plasma Cell Dyscrasias and the Kidney

Cited by 4 publications

References 89 publications

Mesangial Immunoglobulin A Deposits in Minimal Change Nephrotic Syndrome: A Report of an Older Patient and Review of the Literature

Mesangial Immunoglobulin A Deposits in Minimal Change Nephrotic Syndrome: A Report of an Older Patient and Review of the Literature

Kidney in multiple myeloma and related disorders

Monoclonal Gammopathies and the Kidney

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