Other consequences from monoclonal immunoglobulins/fragments

Renal damage secondary to deposition of monoclonal immunoglobulin can occur due to accumulation of either light chains, heavy chains, or both. These include myeloma kidney (cast nephropathy), light-chain and heavy-chain amyloidosis, and light- and heavy-chain deposition disease. Renal damage secondary to deposition of both chains is far less common. In the great majority of these cases the M-component is immunoglobulin G, but the spectrum of renal lesions associated with monoclonal gammopathy is extensive and depends on the physiochemical properties of the immunoglobulin produced.This chapter discusses two important, but less recognized disorders associated with monoclonal immunoglobulins: membranoproliferative glomerulonephritis and acquired Fanconi syndrome.