monoclonal immunoglobulin deposition disease (MIDD)

Etiology

• monoclonal gammopathy of uncertain significance (MGUS)
• multiple myeloma

Pathology

• disorganized glomerular monoclonal immunoglobulin deposits
  • no beta-pleated sheets,
  • Congo-red negative staining
  • immunoglobulin light chain or immunoglobulin heavy chain deposits
• deposits granular rather than fibrillary on histopathology

Clinical manifestations

• renal failure, proteinuria +/- nephrotic syndrome
  • renal tubular dysfunction
  • hypertension
• hepatomegaly (rare)
• cardiomyopathy (rare)

Laboratory

• urine protein -> proteinuria +/- nephrotic range
• renal biopsy
  • glomeruli stain negative with Congo-red

More general terms

• deposition disease
• paraproteinemia (monoclonal gammopathy)