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

  • Myrto Kostopoulou Department of Nephrology, General Hospital "G. Gennimatas", Athens, Greece
  • Androniki Bechli Department of Nephrology, "Korgialenio-Benakio" Hospital, Athens, Greece
  • Konstantina Tsantila Department of Nephrology, General Hospital "G. Gennimatas", Athens, Greece
  • Hariklia Gakiopoulou Department of Histopathology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
  • Konstantinos Liapis Department of Hematology, General Hospital "G. Gennimatas", Athens, Greece
Keywords: Amyloidosis, light chain deposition disease, fibrillary glomerulonephritis, immunotactoid glomerulonephritis, cryoglobulinemic glomerulonephritis, C3 nephropathy

Abstract

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.
Published
2018-07-18
Section
Reviews