具有肾脏意义的单克隆免疫球蛋白病1例  

1 Case of Monoclonal Gammopathy of Renal Significance

作　　者：黄娟 黄宇珊 蔡珺 杨立文 钟伟强 唐凤英 Huang Juan;Huang Yushan;Cai Jun(Guangdong Medical College,Zhanjiang,Guangdong,524000,China)

机构地区：[1]广东医科大学,广东湛江524000 [2]广东医科大学附属惠州市中心人民医院肾内科,广东惠州516000

出　　处：《黑龙江医学》2025年第9期1115-1117,1121,共4页Heilongjiang Medical Journal

基　　金：国家自然科学青年基金项目(81102684)。

摘　　要：老年女性患者,双下肢浮肿11 d,以肾病综合征为临床表现,伴肾功能损害,无其他系统性疾病表现;免疫固定电泳提示单克隆免疫球蛋白类型为IgG-λ型、血游离Kappa轻链及血游离Lambda轻链升高,两次骨髓涂片均可见单克隆浆细胞,肾活检病理提示膜增生性肾小球肾炎,考虑冷球蛋白血症肾损害可能性大,最终诊断为具有肾脏意义的单克隆免疫球蛋白病(MGRS)。予以硼替佐米+环磷酰胺+地塞米松方案治疗后取得血液学完全缓解。The patient was an elderly female with 11 days of lower limb edema.The clinical manifestations were nephrotic syndrome,mild renal function impairment,without other systemic diease.Immunofixed electrophoresis indicated monoclonal immunoglobulin,including type IgG-λ,serum free Kappa light chain and Lambda light chain,increased.Monoclonal plasma cells were found in two bone marrow smear.Renal biopsy pathology indicated membranous hyperplastic glomerulonephritis and suspected renal damage due to cryoglobulinemia.The final diagnosis was monoclonal gammopathy of renal significance(MGRS).Hematologic complete response was achieved after treatment with the plastizomib+cyclophosphamide+dexamethasone regimen.

关 键 词：单克隆免疫球蛋白血症 肾损害 肾活检 

分 类 号：R692[医药卫生—泌尿科学] R55[医药卫生—外科学]