Monoclonal gammopathy of renal significance: When MGUS is no longer undetermined or insignificant

Nelson Leung, Frank Bridoux, Colin A. Hutchison, Samih H. Nasr, Paul Cockwell, Jean Paul Fermand, Angela Dispenzieri, Kevin W. Song, Robert A. Kyle

Research output: Contribution to journalReview article

258 Scopus citations

Abstract

Multiple myeloma is the most frequent monoclonal gammopathy to involve the kidney; however, a growing number of kidney diseases associated with other monoclonal gammopathies are being recognized. Although many histopathologic patterns exist, they are all distinguished by the monoclonal immunoglobulin (or component) deposits. The hematologic disorder in these patients is more consistent with monoclonal gammopathy of undetermined significance (MGUS) than with multiple myeloma. Unfortunately, due to the limitations of the current diagnostic schema, they are frequently diagnosed as MGUS. Because treatment is not recommended for MGUS, appropriate therapy is commonly withheld. In addition to endstage renal disease, the persistence of the monoclonal gammopathy is associated with high rates of recurrence after kidney transplantation. Preservation and restoration of kidney function are possible with successful treatment targeting the responsible clone. Achievement of hematologic complete response has been shown to prevent recurrence after kidney transplantation. There is a need for a term that properly conveys the pathologic nature of these diseases. We think the term monoclonal gammopathy of renal significance is most helpful to indicate a causal relationship between the monoclonal gammopathy and the renal damage and because the significance of the monoclonal gammopathy is no longer undetermined.

Original languageEnglish (US)
Pages (from-to)4292-4295
Number of pages4
JournalBlood
Volume120
Issue number22
DOIs
StatePublished - Nov 22 2012

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ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Leung, N., Bridoux, F., Hutchison, C. A., Nasr, S. H., Cockwell, P., Fermand, J. P., Dispenzieri, A., Song, K. W., & Kyle, R. A. (2012). Monoclonal gammopathy of renal significance: When MGUS is no longer undetermined or insignificant. Blood, 120(22), 4292-4295. https://doi.org/10.1182/blood-2012-07-445304