Ganeval D, Lacour B, Chopin N, Grünfeld J P
Départment de Néphrologie, Hôpital Necker, Paris, France.
Am J Nephrol. 1990;10 Suppl 1:58-62. doi: 10.1159/000168195.
Proteinuria is frequently found in multiple myeloma and related disorders. Immunofixation electrophoresis is very helpful for the identification and characterization of the monoclonal component. In multiple myeloma, the presence of Bence-Jones (BJ) proteinuria is significantly associated with renal failure. The coexistence of BJ proteinuria and the nephrotic syndrome in myeloma patients should suggest AL amyloidosis or light chain deposition disease. In the latter, BJ proteinuria is absent in 30% of the cases and diagnosis is based on the demonstration of the monoclonal light chain deposits in tissues, predominantly in kidneys.
蛋白尿在多发性骨髓瘤及相关疾病中很常见。免疫固定电泳对单克隆成分的鉴定和特征分析非常有帮助。在多发性骨髓瘤中,本-周(BJ)蛋白尿的存在与肾衰竭显著相关。骨髓瘤患者中BJ蛋白尿与肾病综合征并存应提示AL淀粉样变性或轻链沉积病。在后者中,30%的病例不存在BJ蛋白尿,诊断基于组织中主要在肾脏的单克隆轻链沉积的证实。