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World J Nephrol. Mar 6, 2017; 6(2): 72-78
Published online Mar 6, 2017. doi: 10.5527/wjn.v6.i2.72
Monoclonal gammopathy of renal significance: Diagnostic workup
Sofia O Correia, Sofia Santos, Jorge Malheiro, António Cabrita, La Salete Martins, Josefina Santos
Sofia O Correia, Sofia Santos, Jorge Malheiro, António Cabrita, La Salete Martins, Josefina Santos, Nephrology and Transplant Department, Centro Hospitalar do Porto, 4099-001 Porto, Portugal
Author contributions: All authors equally contributed to this paper with literature review, critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: None of the authors has any potential conflicts of interest related to this study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sofia O Correia, MD, Nephrology and Transplant Department, Centro Hospitalar do Porto, Largo Prof.Abel Salazar, 4099-001 Porto, Portugal. soacorreia@gmail.com
Telephone: +351-222-077500 Fax: +351-222-033189
Received: August 25, 2016
Peer-review started: August 27, 2016
First decision: September 27, 2016
Revised: December 28, 2016
Accepted: January 11, 2017
Article in press: January 14, 2017
Published online: March 6, 2017
Processing time: 192 Days and 13.8 Hours
Abstract

The clinical spectrum of diseases associated with monoclonal gammopathies is wide and they are most commonly the consequence of renal deposition of monoclonal immunoglobulin or its components. The differential diagnosis is difficult and renal biopsy is essential. To distinguish many of these pathologies is necessary to use techniques that are not always available, even in tertiary central hospitals. This review will discuss the clinical presentation, pathologic features, treatment, prognosis and common diagnostic difficulties of these entities.

Keywords: Algorithm; Immunoglobulin; Monoclonal gammopathy of renal significance; M protein; Monoclonal gammopathy of undetermined significance

Core tip: Monoclonal gammopathy of renal significance is a wide group of kidney diseases. We discuss the most common diagnostic difficulties and suggest an algorithm for clinical approach. Screening for monoclonal immunoglobulin and an appropriate hematologic workup are fundamental and, sometimes a difficult challenge. Kidney biopsy is required to determine the exact nature of the lesion and to evaluate the severity of renal disease. Therefore, clinical and pathologic features are also discussed.