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Twitter Poll (December 7, 2018)

Vanessa Moreno, MD
By Vanessa Moreno, MD

Dec 10, 2018

MGRS, Monoclonal gammopathy of renal significance, arkana laboratories, pathology of the kidney

ANSWER: D

MGRS was introduced to acknowledge a clonal plasma cell or B lymphocyte proliferation causing a renal lesion in the absence of hematologic malignancy or other myeloma-defining events; the renal lesion is a consequence of the MIg, which carries major implications for management and prognosis, including the potential for progressive renal injury and ESRD.

MGRS caused by PC is defined as <10% bone marrow plasma cells (BMPCs), <3 g/dl of M protein, and the presence of renal lesions without any other myeloma-defining events (CRAB features; clonal PC ≥60%; serum FLC ratio of ≥100; or >1 focal lesion on magnetic resonance imaging)

References:

Sethi S, Rajkumar SV, D’Agati VD. The complexity and heterogeneity of monoclonal immunoglobulin-associated renal diseases. J Am Soc Nephrol 29: 1810–1823, 2018

Hogan JJ, Weiss BM. Bridging the divide: An Onco-Nephrologic Approach to the Monoclonal Gammopathies of Renal Significance. Clin J Am Soc Nephrol 11:1681-91, 2016

Fermand J-P, Bridoux F, Kyle RA, et al. International Kidney and Monoclonal Gammopathy Research Group: How I Treat Monoclonal Gammopathy of Renal Significance (MGRS). Blood 122: 3583–3590, 2013.

Bridoux F, Leung N, Hutchison CA, et al. International Kidney and Monoclonal Gammopathy Research Group: Diagnosis of Monoclonal Gammopathy of Renal Significance. Kidney Int 87: 698–711, 2015.

Sethi S, Zand L, Leung N, Smith RJH, Jevremonic D, Herrmann SS, et al. Membranoproliferative Glomerulonephritis Secondary to Monoclonal Gammopathy. Clin J Am Soc Nephrol 5: 770–782, 2010.

Leung N, Bridoux F, Hutchison CA, et al. International Kidney and Monoclonal Gammopathy Research Group: Monoclonal Gammopathy of Renal Significance: When MGUS is No Longer Undetermined or Insignificant. Blood 120: 4292–4295, 2012.

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Quick note: This post is to be used for informational purposes only and does not constitute medical or health advice. Each person should consult their own doctor with respect to matters referenced. Arkana Laboratories assumes no liability for actions taken in reliance upon the information contained herein.