Monoclonal gammopathy of renal significance (MGRS) defines renal disease resulting from monoclonal proteins that are secreted from clonal B cells, that does not meet criteria for lymphoma or multiple myeloma. Recognizing MGRS in clinical practice is important because renal outcomes are poor and treatments targeting the underlying clonal disease have been associated with improved renal survival. In this case report, we present a case of a patient with membranoproliferative glomerulonephritis (MPGN) with IgG-kappa deposition who underwent clone directed treatment in a phased approach with induction and maintenance to achieve renal response. This is one of the first cases to report on MGRS treatment that required extended maintenance therapy.
This paper describes a case of adrenal myelolipoma with an unusual characteristic: the presence of bone spicules. The lesion was associated with an accessory adrenal gland containing foci of myeloadiposis. The authors believe that myelolipoma and myeloadiposis are closely associated and are in fact the expression of a single process that is both focal (myeloadiposis) and diffuse (myelolipoma). The process consists of the differentiation of choristomatous primitive mesenchymal cells into hematopoietic tissue, adipose tissue and, in rare cases, bone tissue.
Management of bilateral adrenal myelolipoma without endocrine disorder: About a rare case report