Monoclonal gammopathy of renal significance presenting with cryoglobulinaemia type I associated severe thrombotic microangiopathy.
Eva HesiusKim L W BunthofEric SteenbergenElizabeth A de KortInge KleinJack WetzelsPublished in: Clinical kidney journal (2022)
We report a 53-year-old man who presented with acute renal failure. His medical history revealed a spondyloarthropathy, for which secukinumab was started recently, and a monoclonal gammopathy of unknown significance. Kidney function deteriorated despite the withdrawal of secukinumab and dialysis was started. In the serum, type 1 cryoglobulins were present and a kidney biopsy showed ischaemic glomeruli, with thrombosis of the larger interlobular arteries. Other causes of thrombotic microangiopathy were excluded. Bone marrow immunophenotyping showed 1% monoclonal plasma cells. A diagnosis of monoclonal gammopathy of renal significance was made. Haematological treatment resulted in haematological and renal response.
Keyphrases
- bone marrow
- multiple myeloma
- ankylosing spondylitis
- induced apoptosis
- healthcare
- chronic kidney disease
- liver failure
- mesenchymal stem cells
- pulmonary embolism
- early onset
- single cell
- cell cycle arrest
- cell death
- respiratory failure
- combination therapy
- ultrasound guided
- case report
- cell proliferation
- blood flow
- signaling pathway
- hepatitis b virus
- systemic lupus erythematosus
- smoking cessation
- acute respiratory distress syndrome
- extracorporeal membrane oxygenation