Mesangial proliferative glomerulonephritis with monoclonal immunoglobulin deposits: why nephrobiopsy is crucial

Proliferative glomerulonephritis (GN) with monoclonal immunoglobulin deposits (PGNMIDs) is a recently described entity among the spectrum of gammopathy renal significance (MGRS). The disease limited and manifests in chronic glomerular disease, altered function albuminuria, sometimes nephrotic range. Acute nephritic syndrome rare. Until recently, absence criteria for symptomatic haematological patients Ig-related nephropathies often experienced difficulties getting appropriate chemotherapy. Noticeable progress management was achieved introduction concept significance, which distinguishes situation induced by dangerous small B-cell clones from that undetermined (MGUS) does not feature any end-organ damage. Monoclonal gammapathy an independent kidney “chronic glomerulonephritis”, but condition damage secondary to clonal proliferation. In other words, MGRS precancerous combined requires immediate treatment. Renal prognosis poor, progression end stage 25 % within 30 months frequent early recurrence on allograft. However, recent studies indicate clone-targeted chemotherapy may significantly improve outcomes, opening future perspectives this rare disease.