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10.1159/000526244

http://scihub22266oqcxt.onion/10.1159/000526244
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suck abstract from ncbi

pmid36817291      Glomerular+Dis 2022 ; 2 (4): 153-163
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  • Monoclonal Gammopathy of Renal Significance: Histomorphological Spectrum at a Tertiary Care Center #MMPMID36817291
  • Barwad A; Bajaj V; Singh G; Dinda AK; Sahoo RK; Kumar L; Agarwal SK
  • Glomerular Dis 2022[]; 2 (4): 153-163 PMID36817291show ga
  • INTRODUCTION: The term monoclonal gammopathy of renal significance (MGRS) has been described to include patients with renal manifestations associated with circulating monoclonal proteins with or without a clonal lymphoproliferation (B-cell or plasma cell) and not meeting diagnostic criteria for an overt hematological malignancy. A host of MGRS-associated lesions have been described that involve various renal compartments. Our study describes the histomorphological spectrum of MGRS cases at our center in the last 5 years and description as per the classification system of the International Kidney and Monoclonal Gammopathy Research Group (IKMG). MATERIAL AND METHODS: Retrospective analysis was carried out of all the renal biopsies with characteristic monoclonal immunoglobulin lesions for histopathological diagnosis between years 2015 and 2020 and reviewed by two independent pathologists. RESULTS: Most patients in the study belonged to the fifth decade, with a median age of 50 years (mean 50.14 +/- 10.43) range (24-68 years) with a male preponderance. Most patients presented with proteinuria as the sole manifestation (66.6%). Many of the patients (48%) had an M spike by serum protein electrophoresis or urinary protein electrophoresis with an abnormal serum free light chain assay (60.8%). AL amyloidosis was the most common diagnosis observed on histopathological evaluation (68.7%), followed by light chain deposition disease (10.4%). CONCLUSION: MGRS lesions are infrequently encountered in the practice of nephropathology and pose a diagnostic challenge due to the limitation of a congruent clinical or hematological picture. A thorough histological examination with immunofluorescence and electron microscopy often precipitates in the right diagnosis and prompts timely management.
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