International Urology and Nephrology (2018) 50:1365–1366 https://doi.org/10.1007/s11255-018-1896-8 NEPHROLOGY - LE T TER TO THE EDITOR Which should be the correct treatment for monoclonal gammopathy of renal significance with complement alternative pathway dysregulation (C3 glomerulopathy and atypical hemolytic uremic syndrome): clone-directed or anticomplement therapy? 1 2 Mariana Ciocchini · Carlos G. Musso Received: 2 May 2018 / Accepted: 15 May 2018 / Published online: 28 May 2018 © Springer Science+Business Media B.V., part of Springer Nature 2018 Editor, by: mesangiolysis, microaneurysms, endothelial swelling, cellular proliferation with endothelial or membranopro- Monoclonal gammopathy of renal significance (MGRS) liferative pattern (depending on its degree of evolution) is a recently described hemato-nephrological meta-entity and patchy subcortical renal atrophy according to small induced by monoclonal immunoglobulins (Ig) or humoral artery endarteritis. The presence of thrombi in capillaries is factors secreted by small B-cell clones. MGRS can show a pathognomonic of TMA but their absence does not rule out broad spectrum of renal histopathological patterns which its diagnosis. Moreover, haematological alterations are not can even coexist in the same patient [1, 2]. mandatory for TMA diagnosis [4–6]. C3 glomerulopathy (C3G) and atypical hemolytic uremic C3G and aHUS can overlap, being reported that 6% of syndrome (aHUS), which are the prototype of complement- C3G with monoclonal Ig has
International Urology and Nephrology – Springer Journals
Published: May 28, 2018
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