Treatment with bortezomib in dense deposit disease associated with monoclonal gammopathy of undetermined significance

Pampa-Saico, Saúl; Rodríguez-Mendiola, Nuria; Valles‐Carboneras, Ana; Gomis-Couto, Antonio; Sáiz, Ana; Martínez‐González, Miguel Ángel; Díaz-Domínguez, Marta; Liaño, Fernando

doi:10.1111/bjh.15081

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…In the absence of strategies to block the deposition of the pathogenic protein, the principal therapeutic target is the underlying B-cell clone that secretes it. Treatment options usually involve the use of chemotherapies (melphalan, cyclophosphamide, and bendamustine), dexamethasone, bortezomib, or immunotherapies like rituximab, employed with the goal of preserving renal function and targeting the clonal population of cells that are producing the monoclonal immunoglobulin [25,[43][44][45][46][47]. In the context of renal impairment, certain drugs are preferred, such as cyclophosphamide and bortezomib that are better tolerated than melphalan and lenalidomide.…”

Section: Monoclonal Gammopathy Of Renal Significance (Mgrs)mentioning

confidence: 99%

Monoclonal Gammopathy of Undetermined Significance (MGUS)—Not So Asymptomatic after All

Lomas

Mouhieddine

Tahri

et al. 2020

Cancers

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Monoclonal Gammopathy of Undetermined Significance (MGUS) is considered to be a benign precursor condition that may progress to a lymphoproliferative disease or multiple myeloma. Most patients do not progress to an overt condition, but nevertheless, MGUS is associated with a shortened life expectancy and, in a minority of cases, a number of co-morbid conditions that include an increased fracture risk, renal impairment, peripheral neuropathy, secondary immunodeficiency, and cardiovascular disease. This review aims to consolidate current evidence for the significance of these co-morbidities before considering how best to approach these symptoms and signs, which are often encountered in primary care or within a number of specialties in secondary care.

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Section: Monoclonal Gammopathy Of Renal Significance (Mgrs)mentioning

confidence: 99%

Monoclonal Gammopathy of Undetermined Significance (MGUS)—Not So Asymptomatic after All

Lomas

Mouhieddine

Tahri

et al. 2020

Cancers

View full text Add to dashboard Cite

show abstract

Monoclonal gammopathy of renal significance: Multidisciplinary approach to diagnosis and treatment

Karam

Haidous

Dalle

et al. 2023

Critical Reviews in Oncology/Hematology

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Unusual Cases of Monoclonal Gammopathy of Renal Significance

Chen,

Turcotte,

Higgins

et al. 2024

Case Reports in Nephrology

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Introduction. Monoclonal gammopathy of renal significance (MGRS) is a rare entity describing patients with renal impairment related to the secretion of immunoglobulins without hematological criteria for treatment of a specific disease. We present 3 cases of MGRS identified at our center that were either rare or difficult to diagnose. Case Presentations. The first patient presented with monoclonal membranoproliferative glomerulonephritis in the context of known chronic lymphocytic leukemia (CLL), diagnosed about 10 years prior. She presented with nephritic syndrome with serum protein electrophoresis revealing an IgG/lambda peak of less than 1 g/L, stable from the last few years. A renal biopsy confirmed a diagnosis of monoclonal membranoproliferative glomerulonephritis with granular IgG and C3 deposits of various sizes. The second patient presented with renal TMA in the context of IgM MGUS. The patient was admitted for acute nephritic syndrome and thrombotic microangiopathy. Serum protein electrophoresis demonstrated IgM/kappa paraprotein at 1.8 g/L, with a kappa/lambda ratio of 5.48. Renal biopsy demonstrated endocapillary proliferative glomerulonephritis associated with the presence of numerous monotypic IgM/kappa intracapillary pseudothrombi. Characteristic changes of thrombotic microangiopathy were also described. The third patient presented with immunotactoid glomerulonephritis likely from small B‐cell lymphoma that later transformed to DLBCL. The patient presented with acute renal failure with IgM/kappa paraprotein of less than 1 g/L on electrophoresis and with a kappa/lambda ratio of 7.09. A diagnosis of immunotactoid glomerulonephritis was made on renal biopsy. Bone marrow with limited specimen revealed a B‐cell infiltrate. Biopsy of a breast lesion was compatible with diffuse large B‐cell lymphoma (DLBCL). Lymphomatous cells expressed IgM/kappa, thus confirming paraprotein‐associated renal lesion. Conclusion. We described 3 different cases of MGRS, highlighting the diversity of renal pathohistological presentations and different associated lymphoproliferative disorders. Biopsy should rapidly be considered, as early diagnosis of MGRS is essential to initiate clone‐directed therapy promptly to prevent progression to ESRD or hematologic progression to malignancy.

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Treatment with bortezomib in dense deposit disease associated with monoclonal gammopathy of undetermined significance

Cited by 3 publications

References 9 publications

Monoclonal Gammopathy of Undetermined Significance (MGUS)—Not So Asymptomatic after All

Monoclonal Gammopathy of Undetermined Significance (MGUS)—Not So Asymptomatic after All

Monoclonal gammopathy of renal significance: Multidisciplinary approach to diagnosis and treatment

Unusual Cases of Monoclonal Gammopathy of Renal Significance

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