Monoclonal gammopathy of renal significance presenting with cryoglobulinaemia type I associated severe thrombotic microangiopathy

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Hesius, Eva, Bunthof, Kim, Steenbergen, Eric, de Kort, Elizabeth, Klein, Inge, Wetzels, Jack
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Exceptional Case
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9217659/
https://www.ncbi.nlm.nih.gov/pubmed/35756736
http://dx.doi.org/10.1093/ckj/sfac078
_version_ 1784731698846498816
author Hesius, Eva
Bunthof, Kim
Steenbergen, Eric
de Kort, Elizabeth
Klein, Inge
Wetzels, Jack
author_facet Hesius, Eva
Bunthof, Kim
Steenbergen, Eric
de Kort, Elizabeth
Klein, Inge
Wetzels, Jack
author_sort Hesius, Eva
collection PubMed
description 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.
format Online
Article
Text
id pubmed-9217659
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-92176592022-06-23 Monoclonal gammopathy of renal significance presenting with cryoglobulinaemia type I associated severe thrombotic microangiopathy Hesius, Eva Bunthof, Kim Steenbergen, Eric de Kort, Elizabeth Klein, Inge Wetzels, Jack Clin Kidney J Exceptional Case 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. Oxford University Press 2022-03-12 /pmc/articles/PMC9217659/ /pubmed/35756736 http://dx.doi.org/10.1093/ckj/sfac078 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the ERA. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Exceptional Case
Hesius, Eva
Bunthof, Kim
Steenbergen, Eric
de Kort, Elizabeth
Klein, Inge
Wetzels, Jack
Monoclonal gammopathy of renal significance presenting with cryoglobulinaemia type I associated severe thrombotic microangiopathy
title Monoclonal gammopathy of renal significance presenting with cryoglobulinaemia type I associated severe thrombotic microangiopathy
title_full Monoclonal gammopathy of renal significance presenting with cryoglobulinaemia type I associated severe thrombotic microangiopathy
title_fullStr Monoclonal gammopathy of renal significance presenting with cryoglobulinaemia type I associated severe thrombotic microangiopathy
title_full_unstemmed Monoclonal gammopathy of renal significance presenting with cryoglobulinaemia type I associated severe thrombotic microangiopathy
title_short Monoclonal gammopathy of renal significance presenting with cryoglobulinaemia type I associated severe thrombotic microangiopathy
title_sort monoclonal gammopathy of renal significance presenting with cryoglobulinaemia type i associated severe thrombotic microangiopathy
topic Exceptional Case
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9217659/
https://www.ncbi.nlm.nih.gov/pubmed/35756736
http://dx.doi.org/10.1093/ckj/sfac078
work_keys_str_mv AT hesiuseva monoclonalgammopathyofrenalsignificancepresentingwithcryoglobulinaemiatypeiassociatedseverethromboticmicroangiopathy
AT bunthofkim monoclonalgammopathyofrenalsignificancepresentingwithcryoglobulinaemiatypeiassociatedseverethromboticmicroangiopathy
AT steenbergeneric monoclonalgammopathyofrenalsignificancepresentingwithcryoglobulinaemiatypeiassociatedseverethromboticmicroangiopathy
AT dekortelizabeth monoclonalgammopathyofrenalsignificancepresentingwithcryoglobulinaemiatypeiassociatedseverethromboticmicroangiopathy
AT kleininge monoclonalgammopathyofrenalsignificancepresentingwithcryoglobulinaemiatypeiassociatedseverethromboticmicroangiopathy
AT wetzelsjack monoclonalgammopathyofrenalsignificancepresentingwithcryoglobulinaemiatypeiassociatedseverethromboticmicroangiopathy

Ejemplares similares