Progression of IgM Monoclonal Gammopathy of Renal Significance (MGRS) to Symptomatic Waldenström Macroglobulinemia: A Case Report

ABSTRACT Background Monoclonal gammopathy of renal significance (MGRS) is characterized as renal impairment caused by monoclonal protein but does not fulfill the criteria for specific hematologic malignancies. Most MGRS cases involve IgG, IgA, or light chains, but IgM‐MGRS remains poorly understood....

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Main Authors: Kenichi Ito, Hiroaki Shimoyamada, Kazuhiko Hirano, Naohiro Sekiguchi
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Cancer Reports
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Online Access:https://doi.org/10.1002/cnr2.70281
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author Kenichi Ito
Hiroaki Shimoyamada
Kazuhiko Hirano
Naohiro Sekiguchi
author_facet Kenichi Ito
Hiroaki Shimoyamada
Kazuhiko Hirano
Naohiro Sekiguchi
author_sort Kenichi Ito
collection DOAJ
description ABSTRACT Background Monoclonal gammopathy of renal significance (MGRS) is characterized as renal impairment caused by monoclonal protein but does not fulfill the criteria for specific hematologic malignancies. Most MGRS cases involve IgG, IgA, or light chains, but IgM‐MGRS remains poorly understood. Case We present a 74‐year‐old woman with IgM‐κ monoclonal proteinuria who initially declined further evaluation. Later, anemia was identified, and a systemic work‐up revealed monoclonal immunoglobulin deposition disease in the kidney and symptomatic Waldenström macroglobulinemia. Treatment with a Bruton's tyrosine kinase inhibitor, namely tirabrutinib, rapidly resolved both proteinuria and anemia. Conclusion This case highlights the importance of early renal biopsy and prompt intervention in suspected IgM‐MGRS.
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spelling doaj-art-dcfdbf4bba9946f9ba87b965b85d12bd2025-08-20T02:48:42ZengWileyCancer Reports2573-83482025-07-0187n/an/a10.1002/cnr2.70281Progression of IgM Monoclonal Gammopathy of Renal Significance (MGRS) to Symptomatic Waldenström Macroglobulinemia: A Case ReportKenichi Ito0Hiroaki Shimoyamada1Kazuhiko Hirano2Naohiro Sekiguchi3Hematology Division National Hospital Organization Disaster Medical Center Tokyo JapanPathology Division Dokkyo Medical University Saitama Medical Center Saitama JapanLaboratory and Pathology Division National Hospital Organization Disaster Medical Center Tokyo JapanHematology Division National Hospital Organization Disaster Medical Center Tokyo JapanABSTRACT Background Monoclonal gammopathy of renal significance (MGRS) is characterized as renal impairment caused by monoclonal protein but does not fulfill the criteria for specific hematologic malignancies. Most MGRS cases involve IgG, IgA, or light chains, but IgM‐MGRS remains poorly understood. Case We present a 74‐year‐old woman with IgM‐κ monoclonal proteinuria who initially declined further evaluation. Later, anemia was identified, and a systemic work‐up revealed monoclonal immunoglobulin deposition disease in the kidney and symptomatic Waldenström macroglobulinemia. Treatment with a Bruton's tyrosine kinase inhibitor, namely tirabrutinib, rapidly resolved both proteinuria and anemia. Conclusion This case highlights the importance of early renal biopsy and prompt intervention in suspected IgM‐MGRS.https://doi.org/10.1002/cnr2.70281monoclonal gammopathy of renal significancemonoclonal immunoglobulin deposition diseaseTirabrutinibWaldenstrom macroglobulinemia
spellingShingle Kenichi Ito
Hiroaki Shimoyamada
Kazuhiko Hirano
Naohiro Sekiguchi
Progression of IgM Monoclonal Gammopathy of Renal Significance (MGRS) to Symptomatic Waldenström Macroglobulinemia: A Case Report
Cancer Reports
monoclonal gammopathy of renal significance
monoclonal immunoglobulin deposition disease
Tirabrutinib
Waldenstrom macroglobulinemia
title Progression of IgM Monoclonal Gammopathy of Renal Significance (MGRS) to Symptomatic Waldenström Macroglobulinemia: A Case Report
title_full Progression of IgM Monoclonal Gammopathy of Renal Significance (MGRS) to Symptomatic Waldenström Macroglobulinemia: A Case Report
title_fullStr Progression of IgM Monoclonal Gammopathy of Renal Significance (MGRS) to Symptomatic Waldenström Macroglobulinemia: A Case Report
title_full_unstemmed Progression of IgM Monoclonal Gammopathy of Renal Significance (MGRS) to Symptomatic Waldenström Macroglobulinemia: A Case Report
title_short Progression of IgM Monoclonal Gammopathy of Renal Significance (MGRS) to Symptomatic Waldenström Macroglobulinemia: A Case Report
title_sort progression of igm monoclonal gammopathy of renal significance mgrs to symptomatic waldenstrom macroglobulinemia a case report
topic monoclonal gammopathy of renal significance
monoclonal immunoglobulin deposition disease
Tirabrutinib
Waldenstrom macroglobulinemia
url https://doi.org/10.1002/cnr2.70281
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