Reducing diagnostic errors — Recognizing monoclonal gammopathy of renal significance (MGRS)

Myrto Kostopoulou, Androniki Bechli, Konstantina Tsantila, Hariklia Gakiopoulou, Konstantinos Liapis


Recently, the term monoclonal gammopathy of renal significance (MGRS) was used to describe monoclonal gammopathies capable of causing kidney damage resulting in chronic kidney impairement and end-stage renal disease. By definition, patients with MGRS have small plasma-cell or B-cell clones that do not meet the criteria for multiple myeloma or lymphoma, and are frequently mistaken as monoclonal gammopathies of undetermined significance (MGUS). As treatment is not recommended for MGUS, appropriate therapy is commonly withheld. Therefore, a high index of clinical suspicion for MGRS and a multidisciplinary approach are essential to avoid delayed diagnosis and the development of MGRS-related end-stage renal disease.


Amyloidosis; light chain deposition disease; fibrillary glomerulonephritis; immunotactoid glomerulonephritis; cryoglobulinemic glomerulonephritis; C3 nephropathy

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