Hiromura Keiju, Nojima Yoshihisa
Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine.
Nihon Rinsho. 2007 Dec;65(12):2229-34.
Renal involvement is common in multiple myeloma. Although several types of renal disease are observed, most of them are considered to be specifically related to monoclonal immunoglobulin light chains. Myeloma cast nephropathy is the most frequent and sometimes associated with acute renal failure. AL amyloidosis and monoclonal immunoglobulin deposit disease are often presented as a nephrotic syndrome. In this review, we describe the pathogenesis and diagnosis of these three renal diseases. We also focus on the treatment of renal disease in multiple myeloma, in the view points of the chemotherapy to reduce M-protein and the prevention to reduce the risks of promoting renal injury.
肾脏受累在多发性骨髓瘤中很常见。虽然观察到几种类型的肾脏疾病,但大多数被认为与单克隆免疫球蛋白轻链有特定关系。骨髓瘤管型肾病最为常见,有时与急性肾衰竭相关。AL淀粉样变性和单克隆免疫球蛋白沉积病常表现为肾病综合征。在本综述中,我们描述了这三种肾脏疾病的发病机制和诊断。我们还从降低M蛋白的化疗以及预防以降低促进肾损伤风险的角度,重点关注多发性骨髓瘤中肾脏疾病的治疗。