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Thrombotic microangiopathy with intraglomerular IgM pseudothrombi in Waldenström macroglobulinemia and IgM monoclonal gammopathy

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Abstract

IgM secreting myelomas or lymphomas, including Waldenström macroglobulinemia, are associated with a varied spectrum of renal pathology, including intracapillary hyaline deposits, cryoglobulin, membranoproliferative glomerulonephritis, amyloid, monoclonal immunoglobulin deposition disease, cast nephropathy, and lymphoma infiltration. We report our single institution experience, and describe five cases with distinctive glomerular pathology: intracapillary IgM pseudothrombi and thrombotic microangiopathic change, with glomerular intracellular crystals in two biopsies. Two patients were hypocomplementemic at presentation. This series adds to the recent literature on paraprotein associated thrombotic microangiopathy.

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Acknowledgements

The authors thank Norm Cyr for expert assistance with digital and graphical figures. This data was presented in abstract form at the United States & Canadian Academy of Pathology meeting in Vancouver, BC, Canada, March 2018.

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Correspondence to Megan Leigh Troxell.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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This study was approved by the Institutional Review Board at Stanford University Medical Center (#37478), with a waiver of patient consent.

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Tan, S.Y.S., Sibley, R.K., Belani, S. et al. Thrombotic microangiopathy with intraglomerular IgM pseudothrombi in Waldenström macroglobulinemia and IgM monoclonal gammopathy. J Nephrol 31, 907–918 (2018). https://doi.org/10.1007/s40620-018-0544-9

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  • DOI: https://doi.org/10.1007/s40620-018-0544-9

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