Kaplan A A
Department of Medicine, University of Connecticut Health Center, Farmington 06030, USA.
Ther Apher. 2001 Jun;5(3):171-5.
Disordered immunoglobulin synthesis can result in a variety of different types of renal pathology. Multiple myeloma is often associated with the overproduction of light chains which may result in toxicity to the renal tubules and acute renal failure. Patients with mixed cryoglobulinemia will have renal involvement which is most often in the form of a membranoproliferative glomerulonephritis. Renal involvement in macroglobulinemia is relatively uncommon, but IgM thrombi can be so voluminous as to occlude the glomerular capillary lumen. In each of these examples, therapeutic plasma exchange has been found to be a useful adjunct to the eventual chemotherapy required for the definitive treatment of these disorders.
免疫球蛋白合成紊乱可导致多种不同类型的肾脏病理改变。多发性骨髓瘤常与轻链过度产生有关，这可能导致肾小管毒性和急性肾衰竭。混合性冷球蛋白血症患者会出现肾脏受累，最常见的形式是膜增生性肾小球肾炎。巨球蛋白血症中的肾脏受累相对少见，但IgM血栓可能非常大，以至于阻塞肾小球毛细血管腔。在上述每个例子中，治疗性血浆置换已被发现是这些疾病最终确定性治疗所需化疗的有用辅助手段。
