TY - JOUR
T1 - Kidney involvement of patients with Waldenström macroglobulinemia and other IgM-producing B cell lymphoproliferative disorders
AU - Higgins, Larissa
AU - Nasr, Samih H.
AU - Said, Samar M.
AU - Kapoor, Prashant
AU - Dingli, David
AU - King, Rebecca L.
AU - Rajkumar, S. Vincent
AU - Kyle, Robert A.
AU - Kourelis, Taxiarchis
AU - Gertz, Morie A.
AU - Dispenzieri, Angela
AU - Lacy, Martha Q.
AU - Buadi, Francis K.
AU - Ansell, Stephen M.
AU - Gonsalves, Wilson I.
AU - Thompson, Carrie A.
AU - Fervenza, Fernando C.
AU - Zand, Ladan
AU - Hwa, Yi L.
AU - Jevremovic, Dragan
AU - Shi, Min
AU - Leung, Nelson
N1 - Funding Information:
A.D. received research support from Celgene, Takeda, Jannsen, Prothena, Pfizer, and Alnylam. C.A.T. received research support from Celgene. N.L. consults for Prothena and Takeda and received research support from Omeros.
Publisher Copyright:
© 2018 by the American Society of Nephrology.
PY - 2018/7/6
Y1 - 2018/7/6
N2 - Background and objectives Kidney involvement in Waldenström macroglobulinemia is less well described compared with kidney manifestations in multiple myeloma. Design, setting, participants, & measurements Of the 1363 patients seen with Waldenström macroglobulinemia and other IgM-secreting B cell lymphoproliferative disorders seen at the Mayo Clinic between 1996 and 2015, 57 kidney biopsies were retrospectively studied. The biopsy findings were correlated with clinical, kidney, and hematologic characteristics. Criteria for inclusion were evidence of a monoclonal IgM protein and availability of a kidney and a bone marrow biopsy for review. Glomerular and tubulointerstitial pathologies were categorized according to whether they were related to the monoclonal IgM. Results Of the 57 patients identified, monoclonal gammopathy–related kidney lesions were identified in 82% (47 of 57 biopsies), whereas nonmonoclonal gammopathy–related kidney lesions were seen in 18% (ten of 57). Monoclonal gammopathy–related kidney lesions included monoclonal Ig–related amyloidosis (n=19; 33%), nonamyloid glomerulopathy (n=20, 35%), and tubulointerstitial nephropathies (n=8; 14%). The most common monoclonal gammopathy–related kidney lesion was monoclonal Ig–related amyloidosis (n=19; 33%) followed by cryoglobulinemic GN (n=13; 28%). Lymphoma infiltration was the most common tubulointerstitial lesion (n=4; 9%). The hematologic diagnosis was Waldenström macroglobulinemia in 74% (n=42), monoclonal gammopathy of renal significance in 16% (n=9), and marginal zone lymphoma (n=2), chronic lymphocytic leukemia (n=2), and low-grade B cell lymphoma (n=2) in 4% each. Conclusions Our study confirms a diverse variety of kidney lesions in patients with monoclonal IgM gammopathy.
AB - Background and objectives Kidney involvement in Waldenström macroglobulinemia is less well described compared with kidney manifestations in multiple myeloma. Design, setting, participants, & measurements Of the 1363 patients seen with Waldenström macroglobulinemia and other IgM-secreting B cell lymphoproliferative disorders seen at the Mayo Clinic between 1996 and 2015, 57 kidney biopsies were retrospectively studied. The biopsy findings were correlated with clinical, kidney, and hematologic characteristics. Criteria for inclusion were evidence of a monoclonal IgM protein and availability of a kidney and a bone marrow biopsy for review. Glomerular and tubulointerstitial pathologies were categorized according to whether they were related to the monoclonal IgM. Results Of the 57 patients identified, monoclonal gammopathy–related kidney lesions were identified in 82% (47 of 57 biopsies), whereas nonmonoclonal gammopathy–related kidney lesions were seen in 18% (ten of 57). Monoclonal gammopathy–related kidney lesions included monoclonal Ig–related amyloidosis (n=19; 33%), nonamyloid glomerulopathy (n=20, 35%), and tubulointerstitial nephropathies (n=8; 14%). The most common monoclonal gammopathy–related kidney lesion was monoclonal Ig–related amyloidosis (n=19; 33%) followed by cryoglobulinemic GN (n=13; 28%). Lymphoma infiltration was the most common tubulointerstitial lesion (n=4; 9%). The hematologic diagnosis was Waldenström macroglobulinemia in 74% (n=42), monoclonal gammopathy of renal significance in 16% (n=9), and marginal zone lymphoma (n=2), chronic lymphocytic leukemia (n=2), and low-grade B cell lymphoma (n=2) in 4% each. Conclusions Our study confirms a diverse variety of kidney lesions in patients with monoclonal IgM gammopathy.
UR - http://www.scopus.com/inward/record.url?scp=85049781129&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049781129&partnerID=8YFLogxK
U2 - 10.2215/CJN.13041117
DO - 10.2215/CJN.13041117
M3 - Article
C2 - 29848505
AN - SCOPUS:85049781129
SN - 1555-9041
VL - 13
SP - 1037
EP - 1046
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 7
ER -