Monoclonal gammopathy of renal significance (MGRS) is a clonal cell proliferative disorder, characterized by the production of monoclonal immunoglobulins in patients that do not meet hematological criteria for a specific malignancy. It can be present in B cell and plasma cell clonal proliferative diseases and accounts for 10% of monoclonal gammopathy of undetermined significance (MGUS) cases. We present a case of a patient presenting with acute kidney injury, hematuria, and nephrotic syndrome, who after renal biopsy was diagnosed with a proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMIDs), a subtype of MGRS, and treated with chemoimmunotherapy (daratumumab, cyclophosphamide, bortezomib, and dexamethasone), with complete renal function recovery.
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Larrazabal et al. (2026) studied this question.
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