Schiavone Giulia, Catapano Fausta, Ratto Enza, Fabbrizio Benedetta, Mancini Elena
IRCCS Azienda Ospedaliero-Universitaria di Bologna. U.O. Nefrologia, Dialisi, Ipertensione, Bologna, Italy.
IRCCS Azienda Ospedaliero-Universitaria di Bologna. SSD Diagnostica Istopatologica e Molecolare degli Organi Solidi e del relativo Trapianto, Bologna, Italy.
G Ital Nefrol. 2022 Apr 21;39(2):2022-vol2.
Diagnosis of monoclonal gammopathy of renal significance (MGRS) with histopathologic features of proliferative GN with monoclonal immunoglobulin deposits (PGNMID) is a challenge for clinicians because of the absence of laboratory findings suggestive of glomerular involvement in paraproteinemia. Renal biopsy remains the gold standard for diagnosis of PGNMID because it is a monoclonal gammopathy with kidney damage often "without a detectable serum/urine clone". Through this case report, we want to focus on the complexity both in the diagnostic process and in monitoring the renal-hematological response to therapy.
诊断具有增殖性肾小球肾炎伴单克隆免疫球蛋白沉积（PGNMID）组织病理学特征的具有肾意义的单克隆丙种球蛋白病（MGRS）对临床医生来说是一项挑战，因为缺乏提示副蛋白血症累及肾小球的实验室检查结果。肾活检仍然是诊断PGNMID的金标准，因为它是一种常“无血清/尿克隆可检测”的伴有肾损害的单克隆丙种球蛋白病。通过本病例报告，我们想关注诊断过程以及监测肾脏 - 血液学对治疗反应中的复杂性。
