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Ultrastructural pattern and classification of renal monoclonal immunoglobulin deposits

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Monoclonal Gammopathies and the Kidney

Abstract

There are many renal diseases associated with monoclonal gammopathies. They are heterogeneous in nature and are not always related to the presence of the M component in serum and/or urine. It is particularly important to determine the exact types of immunoglobulin deposited and their monotypy/monoclonality, using specific anti-light chain (LC) conjugates and, in some instances, anti-heavy chain (HC) subclass conjugates. Light microscopy alone may enable the pathologist to define a pattern of renal injury but rarely to define a disease. The histologic pattern and identification of monotypic immunoglobulin deposits in renal tissue are in some cases sufficient for the diagnosis of AL amyloidosis, type I cryoglobulinic glomerulonephritis or ‘Randall type’ MIDD. Electron microscopy is particularly valuable for the precise localization of immunoglobulin deposits and for determining the pattern of deposition: organized, homogeneous (non-organized) or mixed. New entities in the broad spectrum of monoclonal immunoglobulin deposition diseases are emerging from electron microscopy studies of renal diseases related to monoclonal gammopathies. We propose here a comprehensive classification for diseases featuring the deposition in tissues of monoclonal Ig.

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Authors and Affiliations

  1. Service de Nephrologie, CHU La Milétrie, 350 Avenue Jacques Coeur, 86021, Poitiers, France

    G. Touchard

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  1. G. Touchard
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Editors and Affiliations

  1. University Hospital, Poitiers, France

    Guy Touchard

  2. Tenon Hospital, Paris, France

    Pierre Aucouturier  & Pierre Ronco  & 

  3. Necker Hospital, Paris, France

    Olivier Hermine

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Touchard, G. (2003). Ultrastructural pattern and classification of renal monoclonal immunoglobulin deposits. In: Touchard, G., Aucouturier, P., Hermine, O., Ronco, P. (eds) Monoclonal Gammopathies and the Kidney. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-0191-4_10

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  • DOI: https://doi.org/10.1007/978-94-017-0191-4_10

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-90-481-6199-7

  • Online ISBN: 978-94-017-0191-4

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