VINCENT RAJKUMAR: Hi. I'm Vincent Rajkumar, Professor of Medicine at the Mayo Clinic in Rochester, Minnesota. In the November 2013 issue of the Mayo Clinic Proceedings, I have authored an article with Dr. Sanjeev Sethi, also of the Mayo Clinic, on monoclonal gammopathy associated proliferative glomerulonephritis.
Now, Dr. Sethi is going to be discussing the detailed aspects of this paper and the approach to the diagnosis and treatment of this condition. But I just wanted to give you a few words to place this article in context. Monoclonal gammopathies are very common. About 3% to 4% of the general population over the age of 50 have what is called a monoclonal gammopathy of undetermined significance. Typically, when we talk about monoclonal gammopathies, the main risk factors that we think of-- the main conditions that this predisposes to-- is multiple myeloma and related malignancies.
So we know that 1% of patients with monoclonal gammopathies each year progress to the cancer called multiple myeloma or amyloidosis or Waldenstrom's macroglobulinemia. We also know of certain other associations such as amyloidosis, light chain deposition disease, cryoglobulinemia.
In this article, we discuss the pathogenesis of membranoproliferative glomerulonephritis. So far, most of the cases of patients who have proliferative glomerulonephritis are considered idiopathic, that is unknown. We now know that a majority of cases of previously thought to be idiopathic proliferative glomerulonephritis are really due to monoclonal gammopathies. Since monoclonal gammopathies are very prevalent in the general population, this becomes a very important aspect to consider.
In this article, we highlight not just the diagnostic aspects of this condition, but also the specialized laboratory tests that need to be done to identify it. And we propose specific approaches to the treatment of these patients. This is very important because membranoproliferative glomerulonephritis is not a benign disease. It does progress to cause renal failure.
As we discuss in this article, it is now important to consider monoclonal gammopathies whenever a patient is encountered with idiopathic membranoproliferative glomerulonephritis. If a factor is identified, then we can deliver appropriate therapy, which could be very important for the patient and prevent progression to renal failure.
SPEAKER 1: We hope you found this presentation from the content of Mayo Clinic Proceedings valuable. Our journal's mission is to promote the best interests of patients by advancing the knowledge and professionalism of the physician community.
If you're interested in more information about us, our homepage is www.mayoclinicproceedings.org. There you will find access information for our social media content such as additional videos on our YouTube channel or journal updates on Facebook. You can also follow us on Twitter. More information about health care at Mayo Clinic is available at www.mayoclinic.com. This video content is copyrighted by Mayo Foundation for Medical Education and Research.
