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An update on paraprotein-related renal pathology

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Title: An update on paraprotein-related renal pathology
Authors: Kousios, A
Roufosse, C
Item Type: Journal Article
Abstract: Paraproteins are intact monoclonal immunoglobulins (MIg) or isolated MIg heavy or light chains, detected in the blood or urine and caused by a clonal proliferation of B cells or plasma cells. Paraproteins often cause renal injury, referred to here as paraprotein-related renal disease (PPRD), whether the underlying clonal disorder is characterized by high tumour burden requiring treatment or low tumour burden and thus not requiring immediate treatment from the haematological standpoint. For the latter, an important recent update is the introduction of the concept of Monoclonal Gammopathy of Renal Significance (MGRS), in which the renal pathology in itself may justify the use of clone-directed therapies targeting the nephrotoxic clone, in order to preserve renal function. A bewildering array of renal pathology can be caused by paraproteins, affecting all compartments of the kidney – glomeruli, tubules, interstitium and blood vessels. This review aims to provide an overview of the different renal lesions that can be seen, organized by predominant compartment affected, with guidance on how to spot them and classify them.
Issue Date: Oct-2019
Date of Acceptance: 1-Aug-2019
URI: http://hdl.handle.net/10044/1/81965
DOI: 10.1016/j.mpdhp.2019.07.004
ISSN: 1756-2317
Publisher: Elsevier BV
Start Page: 408
End Page: 421
Journal / Book Title: Diagnostic Histopathology
Volume: 25
Issue: 10
Copyright Statement: © 2020 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: 1108 Medical Microbiology
Publication Status: Published
Embargo Date: 2021-08-01
Online Publication Date: 2019-08-01
Appears in Collections:Department of Immunology and Inflammation



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