中国实用内科杂志2025，Vol.45Issue(3)：210-215,6.DOI:10.19538/j.nk2025030107
有肾脏意义的单克隆丙种球蛋白病诊治
Diagnosis and treatment of monoclonal gammopathy of renal significance
摘要
Abstract
Monoclonal gammopathy of renal significance(MGRS)refers to the clonal proliferation of plasma cells or B cells that does not meet the diagnostic criteria for malignancy but produces a nephrotoxic monoclonal immunoglobulin that directly or indirectly results in kidney injury.MGRS includes light chain amyloidosis,monoclonal immunoglobulin deposition disease,proliferative glomerulonephritis with monoclonal IgG deposits,immunotactoid glomerulopathy,fibrillary glomerulonephritis,C3 glomerulopathy and thrombotic microangiopathy.The diagnosis of MGRS relies on renal biopsy including light microscopy,immunopathological examination,and electron microscopy,combined with bone marrow biopsy and relevant clinical examinations.It is crucial to determine whether the clonal proliferation is of plasma cell or B-cell origin,then anti-plasma cell or anti-B cell therapy,or autologous stem cell transplantation will be performed.The goal of treatment is to achieve hematological and organ remission to improve patient prognosis.MGRS is prone to relapse after transplantation,necessitating close follow-up.关键词
有肾脏意义的单克隆丙种球蛋白病/轻链型淀粉样变/单克隆免疫球蛋白沉积病/增生性肾小球肾炎伴单克隆免疫球蛋白沉积Key words
monoclonal gammopathy of renal significance/light chain amyloidosis/monoclonal immunoglobulin deposition disease/proliferative glomerulonephritis with monoclonal IgG deposits分类
医药卫生引用本文复制引用
曾彩虹..有肾脏意义的单克隆丙种球蛋白病诊治[J].中国实用内科杂志,2025,45(3):210-215,6.基金项目
国家自然科学基金面上项目(82070793) （82070793）
江苏省卫生健康委医学科研重点项目(ZD2021018) （ZD2021018）
