Clinicopathologic characteristics and prognostic analysis of monoclonal gammopathy of renal significance (MGRS) in patients with IgM monoclonal gammopathy: a case series
Abstract Monoclonal gammopathy has emerged as an important cause of renal injury. Since the clinicopathologic features related to monotypic monoclonal gammopathy of renal significance with IgM monoclonal gammopathy (IgM-MGRS) are poorly described and it is uncertain if intervention improves renal su...
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| Format: | Article |
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Nature Portfolio
2022-10-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-21152-0 |
| _version_ | 1811238832874455040 |
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| author | Jing Liu Dandan Liang Shaoshan Liang Feng Xu Xianghua Huang Song Jiang Jinhua Hou |
| author_facet | Jing Liu Dandan Liang Shaoshan Liang Feng Xu Xianghua Huang Song Jiang Jinhua Hou |
| author_sort | Jing Liu |
| collection | DOAJ |
| description | Abstract Monoclonal gammopathy has emerged as an important cause of renal injury. Since the clinicopathologic features related to monotypic monoclonal gammopathy of renal significance with IgM monoclonal gammopathy (IgM-MGRS) are poorly described and it is uncertain if intervention improves renal survival and mortality, we report a series of such patients, characterizing their clinicopathologic spectrum and outcomes. We retrospectively analyzed 38 patients referred to one medical center between 2009 and 2019 with detectable serum monoclonal IgM by immunofixation, performance of a bone marrow biopsy and kidney biopsy-proven MGRS. Of the 38 patients identified, about half patients were amyloidosis, followed by cryoglobulinemic glomerulonephritis. Patients were divided into two groups on the basis of their kidney pathology: amyloid and non-amyloid. Patients with non-amyloidosis were more likely to have renal dysfunction, hematuria, anemia and hypocomplementemia and κ light chain was predominant in this sub-group. Amyloid patients were more often treated with chemotherapy than the non-amyloid patients (P = 0.002). There were no significant differences between amyloid and non-amyloid patients in mortality (48% vs 29%, P = 0.467) and incidence of ESRD (19% vs 59%, P = 0.103). The incidence of ESRD was lower in patients treated with chemotherapy and/or ASCT, compared to those without chemotherapy (25% vs 57%, P = 0.049), and it was also lower in the hematologic responders than non-responders (10% vs 40%, P = 0.047). Our study confirmed a diverse variety of clinicopathological features and outcomes in patients with IgM-MGRS. Chemotherapy and/or ASCT and deep hematologic responses might improve renal prognosis. |
| first_indexed | 2024-04-12T12:49:20Z |
| format | Article |
| id | doaj.art-38eb3616e61f45f5b6f2bd646e11d29b |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-12T12:49:20Z |
| publishDate | 2022-10-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj.art-38eb3616e61f45f5b6f2bd646e11d29b2022-12-22T03:32:31ZengNature PortfolioScientific Reports2045-23222022-10-011211910.1038/s41598-022-21152-0Clinicopathologic characteristics and prognostic analysis of monoclonal gammopathy of renal significance (MGRS) in patients with IgM monoclonal gammopathy: a case seriesJing Liu0Dandan Liang1Shaoshan Liang2Feng Xu3Xianghua Huang4Song Jiang5Jinhua Hou6National Clinical Research Center of Kidney Diseases, Jinling Hospital, Jinling Clinical Medical College of Nanjing Medical UniversityNational Clinical Research Center of Kidney Diseases, Jinling Hospital, Jinling Clinical Medical College of Nanjing Medical UniversityNational Clinical Research Center of Kidney Diseases, Jinling Hospital, Jinling Clinical Medical College of Nanjing Medical UniversityNational Clinical Research Center of Kidney Diseases, Jinling Hospital, Jinling Clinical Medical College of Nanjing Medical UniversityNational Clinical Research Center of Kidney Diseases, Jinling Hospital, Jinling Clinical Medical College of Nanjing Medical UniversityNational Clinical Research Center of Kidney Diseases, Jinling Hospital, Jinling Clinical Medical College of Nanjing Medical UniversityNational Clinical Research Center of Kidney Diseases, Jinling Hospital, Jinling Clinical Medical College of Nanjing Medical UniversityAbstract Monoclonal gammopathy has emerged as an important cause of renal injury. Since the clinicopathologic features related to monotypic monoclonal gammopathy of renal significance with IgM monoclonal gammopathy (IgM-MGRS) are poorly described and it is uncertain if intervention improves renal survival and mortality, we report a series of such patients, characterizing their clinicopathologic spectrum and outcomes. We retrospectively analyzed 38 patients referred to one medical center between 2009 and 2019 with detectable serum monoclonal IgM by immunofixation, performance of a bone marrow biopsy and kidney biopsy-proven MGRS. Of the 38 patients identified, about half patients were amyloidosis, followed by cryoglobulinemic glomerulonephritis. Patients were divided into two groups on the basis of their kidney pathology: amyloid and non-amyloid. Patients with non-amyloidosis were more likely to have renal dysfunction, hematuria, anemia and hypocomplementemia and κ light chain was predominant in this sub-group. Amyloid patients were more often treated with chemotherapy than the non-amyloid patients (P = 0.002). There were no significant differences between amyloid and non-amyloid patients in mortality (48% vs 29%, P = 0.467) and incidence of ESRD (19% vs 59%, P = 0.103). The incidence of ESRD was lower in patients treated with chemotherapy and/or ASCT, compared to those without chemotherapy (25% vs 57%, P = 0.049), and it was also lower in the hematologic responders than non-responders (10% vs 40%, P = 0.047). Our study confirmed a diverse variety of clinicopathological features and outcomes in patients with IgM-MGRS. Chemotherapy and/or ASCT and deep hematologic responses might improve renal prognosis.https://doi.org/10.1038/s41598-022-21152-0 |
| spellingShingle | Jing Liu Dandan Liang Shaoshan Liang Feng Xu Xianghua Huang Song Jiang Jinhua Hou Clinicopathologic characteristics and prognostic analysis of monoclonal gammopathy of renal significance (MGRS) in patients with IgM monoclonal gammopathy: a case series Scientific Reports |
| title | Clinicopathologic characteristics and prognostic analysis of monoclonal gammopathy of renal significance (MGRS) in patients with IgM monoclonal gammopathy: a case series |
| title_full | Clinicopathologic characteristics and prognostic analysis of monoclonal gammopathy of renal significance (MGRS) in patients with IgM monoclonal gammopathy: a case series |
| title_fullStr | Clinicopathologic characteristics and prognostic analysis of monoclonal gammopathy of renal significance (MGRS) in patients with IgM monoclonal gammopathy: a case series |
| title_full_unstemmed | Clinicopathologic characteristics and prognostic analysis of monoclonal gammopathy of renal significance (MGRS) in patients with IgM monoclonal gammopathy: a case series |
| title_short | Clinicopathologic characteristics and prognostic analysis of monoclonal gammopathy of renal significance (MGRS) in patients with IgM monoclonal gammopathy: a case series |
| title_sort | clinicopathologic characteristics and prognostic analysis of monoclonal gammopathy of renal significance mgrs in patients with igm monoclonal gammopathy a case series |
| url | https://doi.org/10.1038/s41598-022-21152-0 |
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