Table 2.

Incidence of detectable monoclonal protein, most commonly found MGs, and the reported hematological disorders associated with MGRS

Type of monoclonal immunoglobulin depositionAssociated renal pathologiesIncidence of detectable MGMost common type of paraprotein/MGAssociated hematological disorders
Intact immunoglobulin molecule/immunoglobulin molecule with truncated heavy chain*ALH amyloidosis4,10,28,29*97%-100%IgGλMM, CLL
LHCDD10,28,29,46,47*SPEP/IFE: 80%-100%IgGκMM (50%)
UPEP/IFE: 80%-100%
sFLC assay: 100%
Cryoglobulinemic GN28,29,48,49Type 1: 76%-82.5%Type I IgG/IgM with κType 1: MM, WM, CLL, B-NHL, MGRS, HCL
Type 2: 40%-49%Type II IgMκType 2: B-CLPD, LPL, MALToma, WM
PGNMID10,29,31,5020%-30%IgG3Rare (4.4%): MM, CLL, NHL
ITG9,28,29,5163%-71%IgG1CLL (19%), LPL (13%), MM (13%)
FG28,52-5415%-17%IgGMM, CLL
Light chains onlyAL amyloidosis4,10,28,2997%-100%VIMM, LPL, CLL
LCDD10,28,29,46,47SPEP/IFE: 25%-76%IVMM (39%-59%), MGRS (39%), LPL
UPEP/IFE: 42%-90%
sFLC assay: 100%
LCPT9,28,29,41,5593.4%-97%IMGRS (27%-46%), MM (14%-33%), SMM (15%-51%), NHL (4%), CLL (2%), WM (8%)
CSH9,28,29,5681.8%-90%κMM, LPL, MGRS (rare)
Heavy chains onlyAH amyloidosis4,10,28,29*97%-100%IgGMM
HCDD10,28,29,46,47*SPEP/IFE: 67%-100%IgG1MM (29%)
UPEP/IFE: 50%-100%
sFLC assay: 100%
No monoclonal protein xdemonstrable in kidneysC3G (C3GN and DDD)28,29,45,57-6033%-83% IgGκMGRS (60%-77.8%), MM (4%-13.9%), SMM (5.6%-30%), CLL/lymphoma (5.6%-6%), type 1 cryoglobulinemia (2.8%)
TMA29,5713.7% (>50 y, 21%; >60 y, 24%)IgGκMGRS (75%), MM (5%), SMM (5%), POEMS (10%), T-cell lymphocytic leukemia (5%)
AtypicalMN secondary to monoclonal immunoglobulin19,370%-21.4%IgG1κCLL/SLL (17.8%-28.5%), MM (7.1%), SMZL (3%)
  • B-CLPD, B-cell chronic lymphoproliferative disorder; B-NHL, B-cell NHL; DDD, dense deposition disease; HCL, hairy cell leukemia; IFE, immunofixation electrophoresis; LHCDD, light and heavy chain deposition disease; LPL, lymphoplasmacytic lymphoma; MALToma, mucosa-associated lymphoid tissue lymphoma; SLL, small lymphocytic lymphoma; SMZL, splenic marginal zone lymphoma; SPEP, serum protein electrophoresis; UPEP, urine protein electrophoresis.

  • * Shows entities with truncated heavy chains.

  • Provisional MGRS entities.