Proteinuria en discrasias de células plasmáticas

Abstract

In the study of proteinuria in plasma cell dyscrasias, the central role belongs to the Bence Jones protein (BJP) and the dysfunction caused by its deposition in various organs. The BJP may be present in all types of gammopathies but has particular interest in multiple myeloma (MM), Amyloidosis (AL) and light chain deposition disease (LCDD). The renal changes associated with the production of monoclonal free light chains (mFLC) are Myeloma nephropathy or myeloma kidney wich produces tubule-interstitial damage, AL with deposition of amyloid fibrils and LCDD with deposition of no amyloid fibril type. The simultaneous determination of PTU, immunofixation and electrophoresis allowed to monitor urinary monoclonal component (MC). Urinary profiles vary during the course of the disease and often exhibit different characteristics at diagnosis for the different types of gammopathies. In 2012 Robert Kyle and colleagues propose the term Monoclonal Gammopathy of Renal Significance (MGRS) to describe blood disorders leading to renal failure, in these cases should be investigated the CM circulating protein by electrophoresis and immunofixation and also demonstrate its deposit in kidney and bone marrow biopsy.