BACKGROUND Monoclonal immunoglobulin can cause renal damage,with a wide spectrum of pathological changes and clinical manifestations without hematological evidence of malignancy.These disorders can be missed,especiall...BACKGROUND Monoclonal immunoglobulin can cause renal damage,with a wide spectrum of pathological changes and clinical manifestations without hematological evidence of malignancy.These disorders can be missed,especially when combined with other kidney diseases.CASE SUMMARY A 61-year-old woman presented with moderate proteinuria with normal renal function.She was diagnosed with IgA nephropathy combined with monoclonal gammopathy of undetermined significance after the first renal biopsy.Although having received immunosuppressive treatment for 3 years,the patient developed nephrotic syndrome.Repeated renal biopsy and laser microdissection/mass spectrometry analysis confirmed heavy chain amyloidosis.After nine cycles of bortezomib,cyclophosphamide and dexamethasone,she achieved very good partial hematological and kidney responses.CONCLUSION Renal injury should be monitored closely in monoclonal gammopathy patients without obvious hematological malignancy,especially in patients with other preexisting renal diseases.展开更多
To the Editor：A 50-year-old man was admitted to Peking Union Medical College Hospital with recurrent abdominal pain,vomiting,and melena.In the past 2 years,he had visited several hospitals for abdominal discomfort an...To the Editor：A 50-year-old man was admitted to Peking Union Medical College Hospital with recurrent abdominal pain,vomiting,and melena.In the past 2 years,he had visited several hospitals for abdominal discomfort and was diagnosed as ileus or subileus.Normal mucosa was shown in both gastroscopy and colonoscopy.展开更多
文摘BACKGROUND Monoclonal immunoglobulin can cause renal damage,with a wide spectrum of pathological changes and clinical manifestations without hematological evidence of malignancy.These disorders can be missed,especially when combined with other kidney diseases.CASE SUMMARY A 61-year-old woman presented with moderate proteinuria with normal renal function.She was diagnosed with IgA nephropathy combined with monoclonal gammopathy of undetermined significance after the first renal biopsy.Although having received immunosuppressive treatment for 3 years,the patient developed nephrotic syndrome.Repeated renal biopsy and laser microdissection/mass spectrometry analysis confirmed heavy chain amyloidosis.After nine cycles of bortezomib,cyclophosphamide and dexamethasone,she achieved very good partial hematological and kidney responses.CONCLUSION Renal injury should be monitored closely in monoclonal gammopathy patients without obvious hematological malignancy,especially in patients with other preexisting renal diseases.
文摘To the Editor：A 50-year-old man was admitted to Peking Union Medical College Hospital with recurrent abdominal pain,vomiting,and melena.In the past 2 years,he had visited several hospitals for abdominal discomfort and was diagnosed as ileus or subileus.Normal mucosa was shown in both gastroscopy and colonoscopy.
