Peer-review started: August 27, 2016
First decision: September 27, 2016
Revised: December 28, 2016
Accepted: January 11, 2017
Article in press: January 14, 2017
Published online: March 6, 2017
Processing time: 192 Days and 13.8 Hours
The clinical spectrum of diseases associated with monoclonal gammopathies is wide and they are most commonly the consequence of renal deposition of monoclonal immunoglobulin or its components. The differential diagnosis is difficult and renal biopsy is essential. To distinguish many of these pathologies is necessary to use techniques that are not always available, even in tertiary central hospitals. This review will discuss the clinical presentation, pathologic features, treatment, prognosis and common diagnostic difficulties of these entities.
Core tip: Monoclonal gammopathy of renal significance is a wide group of kidney diseases. We discuss the most common diagnostic difficulties and suggest an algorithm for clinical approach. Screening for monoclonal immunoglobulin and an appropriate hematologic workup are fundamental and, sometimes a difficult challenge. Kidney biopsy is required to determine the exact nature of the lesion and to evaluate the severity of renal disease. Therefore, clinical and pathologic features are also discussed.