eprintid: 10064523 rev_number: 17 eprint_status: archive userid: 608 dir: disk0/10/06/45/23 datestamp: 2018-12-19 15:25:11 lastmod: 2021-09-19 23:35:27 status_changed: 2018-12-19 15:25:11 type: article metadata_visibility: show creators_name: Leung, N creators_name: Bridoux, F creators_name: Batuman, V creators_name: Chaidos, A creators_name: Cockwell, P creators_name: D'Agati, VD creators_name: Dispenzieri, A creators_name: Fervenza, FC creators_name: Fermand, J-P creators_name: Gibbs, S creators_name: Gillmore, JD creators_name: Herrera, GA creators_name: Jaccard, A creators_name: Jevremovic, D creators_name: Kastritis, E creators_name: Kukreti, V creators_name: Kyle, RA creators_name: Lachmann, HJ creators_name: Larsen, CP creators_name: Ludwig, H creators_name: Markowitz, GS creators_name: Merlini, G creators_name: Mollee, P creators_name: Picken, MM creators_name: Rajkumar, VS creators_name: Royal, V creators_name: Sanders, PW creators_name: Sethi, S creators_name: Venner, CP creators_name: Voorhees, PM creators_name: Wechalekar, AD creators_name: Weiss, BM creators_name: Nasr, SH title: The evaluation of monoclonal gammopathy of renal significance: a consensus report of the International Kidney and Monoclonal Gammopathy Research Group ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 divisions: G90 note: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. abstract: The term monoclonal gammopathy of renal significance (MGRS) was introduced by the International Kidney and Monoclonal Gammopathy Research Group (IKMG) in 2012. The IKMG met in April 2017 to refine the definition of MGRS and to update the diagnostic criteria for MGRS-related diseases. Accordingly, in this Expert Consensus Document, the IKMG redefines MGRS as a clonal proliferative disorder that produces a nephrotoxic monoclonal immunoglobulin and does not meet previously defined haematological criteria for treatment of a specific malignancy. The diagnosis of MGRS-related disease is established by kidney biopsy and immunofluorescence studies to identify the monotypic immunoglobulin deposits (although these deposits are minimal in patients with either C3 glomerulopathy or thrombotic microangiopathy). Accordingly, the IKMG recommends a kidney biopsy in patients suspected of having MGRS to maximize the chance of correct diagnosis. Serum and urine protein electrophoresis and immunofixation, as well as analyses of serum free light chains, should also be performed to identify the monoclonal immunoglobulin, which helps to establish the diagnosis of MGRS and might also be useful for assessing responses to treatment. Finally, bone marrow aspiration and biopsy should be conducted to identify the lymphoproliferative clone. Flow cytometry can be helpful in identifying small clones. Additional genetic tests and fluorescent in situ hybridization studies are helpful for clonal identification and for generating treatment recommendations. Treatment of MGRS was not addressed at the 2017 IKMG meeting; consequently, this Expert Consensus Document does not include any recommendations for the treatment of patients with MGRS. date: 2019-01 date_type: published official_url: https://doi.org/10.1038/s41581-018-0077-4 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green article_type_text: Consensus Statement verified: verified_manual elements_id: 1613615 doi: 10.1038/s41581-018-0077-4 pii: 10.1038/s41581-018-0077-4 lyricists_name: Gillmore, Julian lyricists_name: Lachmann, Helen lyricists_name: Wechalekar, Ashutosh lyricists_id: JGILL78 lyricists_id: HJLAC80 lyricists_id: AWECH53 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner full_text_status: public publication: Nature Reviews Nephrology volume: 15 number: 1 pagerange: 45-59 event_location: England issn: 1759-507X citation: Leung, N; Bridoux, F; Batuman, V; Chaidos, A; Cockwell, P; D'Agati, VD; Dispenzieri, A; ... Nasr, SH; + view all <#> Leung, N; Bridoux, F; Batuman, V; Chaidos, A; Cockwell, P; D'Agati, VD; Dispenzieri, A; Fervenza, FC; Fermand, J-P; Gibbs, S; Gillmore, JD; Herrera, GA; Jaccard, A; Jevremovic, D; Kastritis, E; Kukreti, V; Kyle, RA; Lachmann, HJ; Larsen, CP; Ludwig, H; Markowitz, GS; Merlini, G; Mollee, P; Picken, MM; Rajkumar, VS; Royal, V; Sanders, PW; Sethi, S; Venner, CP; Voorhees, PM; Wechalekar, AD; Weiss, BM; Nasr, SH; - view fewer <#> (2019) The evaluation of monoclonal gammopathy of renal significance: a consensus report of the International Kidney and Monoclonal Gammopathy Research Group. Nature Reviews Nephrology , 15 (1) pp. 45-59. 10.1038/s41581-018-0077-4 <https://doi.org/10.1038/s41581-018-0077-4>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10064523/1/s41581-018-0077-4.pdf