کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
8772629 | 1599137 | 2018 | 7 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
A clone-directed approach may improve diagnosis and treatment of proliferative glomerulonephritis with monoclonal immunoglobulin deposits
ترجمه فارسی عنوان
یک رویکرد هدایت شده توسط کلون می تواند تشخیص و درمان گلومرولونفریت پرولیفراتیو را با رسوب های ایمونوگلوبولین منوکلونال بهبود بخشد
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کلمات کلیدی
گلومرولونفریت، لنفوم، میلوم چندگانه برونکوفرولوژی،
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
بیماریهای کلیوی
چکیده انگلیسی
The optimal treatment for the monoclonal gammopathies of renal significance is not known, but there is consensus among experts that treatment should be specific for the underlying clone. The majority of patients with proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) do not have an identifiable clone, and prior studies have found poor renal outcomes for patients with PGNMID treated with a variety of regimens. Here we present a retrospective case series of 19 patients with PGNMID with a more uniform, clone-directed approach. A circulating paraprotein was detected in 37% of patients, and the overall clone detection rate was 32%. Treatment was directed at the underlying clone or, for patients without a detectable clone, empirically prescribed to target the hypothesized underlying clone. Of the 16 patients who underwent treatment, the overall renal response rate was 88%, and 38% of patients experienced complete renal response (proteinuria reduction to under 0.5 gm/24 hours) with initial treatment. All patients were End Stage Renal Disease-free at last follow-up (median 693 days after diagnosis), and treatment was well tolerated. Thus, a clone-directed approach may lead to novel, targeted treatment strategies that could significantly improve outcomes for patients with PGNMID.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Kidney International - Volume 94, Issue 1, July 2018, Pages 199-205
Journal: Kidney International - Volume 94, Issue 1, July 2018, Pages 199-205
نویسندگان
Ramnika Gumber, Jordana B. Cohen, Matthew B. Palmer, Sidney M. Kobrin, Dan T. Vogl, Alan G. Wasserstein, Sunita D. Nasta, Melissa B. Bleicher, Roy D. Bloom, Laura Dember, Adam Cohen, Brendan M. Weiss, Jonathan J. Hogan,