Nefropatías secundarias a paraproteína: perfil clínico a partir de hallazgos histológicos

Background: One of the devastating consequences of monoclonal gammopathies is the development of end-stage kidney disease, which can be prevented with an early diagnosis. Renal involvement can be secondary to saturation of paraproteins with intratubular precipitation or the glomerular deposition of...

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Autores principales:	Jerez,Joaquín, Juanet,Cristián, Sharp,Joaquín, Ernst,Daniel, Méndez,Gonzalo P., Sepúlveda,Rodrigo A.
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2020
Materias:	Glomerulonephritis Multiple Myeloma Nephrotic Syndrome Paraproteinemias Proteinuria
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000801059
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spelling	oai:scielo:S0034-988720200008010592020-12-26Nefropatías secundarias a paraproteína: perfil clínico a partir de hallazgos histológicosJerez,JoaquínJuanet,CristiánSharp,JoaquínErnst,DanielMéndez,Gonzalo P.Sepúlveda,Rodrigo A. Glomerulonephritis Multiple Myeloma Nephrotic Syndrome Paraproteinemias Proteinuria Background: One of the devastating consequences of monoclonal gammopathies is the development of end-stage kidney disease, which can be prevented with an early diagnosis. Renal involvement can be secondary to saturation of paraproteins with intratubular precipitation or the glomerular deposition of paraproteins with secondary inflammation and destruction. These conditions can also be associated with monoclonal gammopathies that do not meet hematological treatment criteria, called monoclonal gammopathies of renal significance (MGRS). Aim: To report a retrospective analysis of patients who underwent a renal biopsy and whose final diagnosis was a form of monoclonal gammopathy. Material and Methods: We reviewed the clinical and laboratory features and response to treatment of 22 patients aged 63 ± 12 years (55% women) with a pathological diagnosis of a nephropathy associated with paraproteinemia. Results: The most common hematological diagnosis was amyloidosis in 50% of patients, followed by cast nephropathy. The predominant clinical presentations were proteinuria (without nephrotic syndrome) and nephritic syndrome. Classic criteria such as erythrocyte sedimentation rate > 100 mm/h and protein-albumin gap were unusual. Serum light chain quantification was the test with the best yield to detect paraproteins. Conclusions: In this group of patients, light chains tend to affect the kidney more commonly than heavy chains. The prognosis of multiple myeloma is much worse than MGRS.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.148 n.8 20202020-08-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000801059es10.4067/S0034-98872020000801059
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Glomerulonephritis Multiple Myeloma Nephrotic Syndrome Paraproteinemias Proteinuria
spellingShingle	Glomerulonephritis Multiple Myeloma Nephrotic Syndrome Paraproteinemias Proteinuria Jerez,Joaquín Juanet,Cristián Sharp,Joaquín Ernst,Daniel Méndez,Gonzalo P. Sepúlveda,Rodrigo A. Nefropatías secundarias a paraproteína: perfil clínico a partir de hallazgos histológicos
description	Background: One of the devastating consequences of monoclonal gammopathies is the development of end-stage kidney disease, which can be prevented with an early diagnosis. Renal involvement can be secondary to saturation of paraproteins with intratubular precipitation or the glomerular deposition of paraproteins with secondary inflammation and destruction. These conditions can also be associated with monoclonal gammopathies that do not meet hematological treatment criteria, called monoclonal gammopathies of renal significance (MGRS). Aim: To report a retrospective analysis of patients who underwent a renal biopsy and whose final diagnosis was a form of monoclonal gammopathy. Material and Methods: We reviewed the clinical and laboratory features and response to treatment of 22 patients aged 63 ± 12 years (55% women) with a pathological diagnosis of a nephropathy associated with paraproteinemia. Results: The most common hematological diagnosis was amyloidosis in 50% of patients, followed by cast nephropathy. The predominant clinical presentations were proteinuria (without nephrotic syndrome) and nephritic syndrome. Classic criteria such as erythrocyte sedimentation rate > 100 mm/h and protein-albumin gap were unusual. Serum light chain quantification was the test with the best yield to detect paraproteins. Conclusions: In this group of patients, light chains tend to affect the kidney more commonly than heavy chains. The prognosis of multiple myeloma is much worse than MGRS.
author	Jerez,Joaquín Juanet,Cristián Sharp,Joaquín Ernst,Daniel Méndez,Gonzalo P. Sepúlveda,Rodrigo A.
author_facet	Jerez,Joaquín Juanet,Cristián Sharp,Joaquín Ernst,Daniel Méndez,Gonzalo P. Sepúlveda,Rodrigo A.
author_sort	Jerez,Joaquín
title	Nefropatías secundarias a paraproteína: perfil clínico a partir de hallazgos histológicos
title_short	Nefropatías secundarias a paraproteína: perfil clínico a partir de hallazgos histológicos
title_full	Nefropatías secundarias a paraproteína: perfil clínico a partir de hallazgos histológicos
title_fullStr	Nefropatías secundarias a paraproteína: perfil clínico a partir de hallazgos histológicos
title_full_unstemmed	Nefropatías secundarias a paraproteína: perfil clínico a partir de hallazgos histológicos
title_sort	nefropatías secundarias a paraproteína: perfil clínico a partir de hallazgos histológicos
publisher	Sociedad Médica de Santiago
publishDate	2020
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000801059
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Nefropatías secundarias a paraproteína: perfil clínico a partir de hallazgos histológicos

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