Mehtat Ünlü Şadiye, Özsan Hayri, Sarıoğlu Sülen
Dokuz Eylül University Faculty of Medicine, Department of Pathology, İzmir, Turkey.
Dokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, Turkey.
Turk J Haematol. 2017 Dec 1;34(4):282-288. doi: 10.4274/tjh.2017.0197. Epub 2017 Aug 23.
Multiple myeloma (MM) is one of the most important clonal malignant plasma cell disorders and renal involvement is associated with poor prognosis. Although there are several reasons for renal impairment in MM, the main cause is the toxic effects of monoclonal proteins. Although cast nephropathy is the best known and unchallenged diagnosis for hematologists and pathologists, the renal effects of monoclonal gammopathy can be various. Monoclonal gammopathy of renal significance was proposed by the International Kidney and Monoclonal Gammopathy Research Group for renal lesions in monoclonal gammopathy in recent years. Renal lesions in monoclonal gammopathy can be grouped as follows: light chain (cast) nephropathy, acute tubular injury/necrosis, tubulointerstitial nephritis, amyloidosis, monoclonal Ig deposition diseases, immunotactoid glomerulopathy, type I cryoglobulinemia, proliferative glomerulonephritis with monoclonal IgG deposits, C3 glomerulopathy with monoclonal gammopathy, and crystal-storing histiocytosis, considering the previous and new terminology. In this study, renal involvement of monoclonal gammopathies, in terms of previous and new terminology, was reviewed.
多发性骨髓瘤（MM）是最重要的克隆性恶性浆细胞疾病之一，肾脏受累与预后不良相关。尽管MM患者肾功能损害有多种原因，但主要原因是单克隆蛋白的毒性作用。虽然管型肾病是血液科医生和病理科医生最熟知且毫无争议的诊断，但单克隆丙种球蛋白病对肾脏的影响可能多种多样。近年来，国际肾脏与单克隆丙种球蛋白病研究小组针对单克隆丙种球蛋白病中的肾脏病变提出了具有肾脏意义的单克隆丙种球蛋白病这一概念。考虑到既往和新的术语，单克隆丙种球蛋白病中的肾脏病变可分为以下几类：轻链（管型）肾病、急性肾小管损伤/坏死、肾小管间质性肾炎、淀粉样变性、单克隆Ig沉积病、免疫触须样肾小球病、I型冷球蛋白血症、伴单克隆IgG沉积的增殖性肾小球肾炎、伴单克隆丙种球蛋白病的C3肾小球病以及贮晶组织细胞增多症。在本研究中，我们根据既往和新的术语对单克隆丙种球蛋白病的肾脏受累情况进行了综述。
