TOPIC DISCUSSION: Waldenstrom Macroglulinemia and Renal disease

WM is a paraprotein disorder that is unique with IgM monoclonal gammopathy. Classically, what is well known is viscosity related injury that might be pre renal or tubular in nature. In addition, glomerular pathology is also not uncommon such as amyloidosis or MPGN. Tubular cast nephropathy is a rare finding with this disease but should always be considered.

Glomerular lesions:
Intracapillary monoclonal deposit disease ( most common)
MPGN
Amyloidosis
LCDD
Minimal change disease
Cryoglobunemic GN

Tubulointerstitial lesions:
Lymphomatous infiltrates
ATN
Cast Nephropathy
Fanconi syndrome

Check out these references:
http://www.ncbi.nlm.nih.gov/pubmed/22721930
http://www.ncbi.nlm.nih.gov/pubmed/23758066
http://www.ncbi.nlm.nih.gov/pubmed/23474147
http://www.ncbi.nlm.nih.gov/pubmed/21655071