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Glomerulopathy in monoclonal immunoglobulin deposition disease (MIDD) develops as a result of granular deposition of subunits of monoclonal immunoglobulins, which can be light chain, heavy chain, or both, with the subsequent development of nodular glomerulosclerosis. These deposits differ from amyloid deposits (see Renal Amyloidosis) by negative metachromatic staining on immunofluorescence and random rather than organized arrangement.
The disease is caused by monoclonal gammopathies and occurs in approximately 5% of patients with plasma cell myeloma.
Renal involvement presents as renal insufficiency and proteinuria of varying degrees. It may improve with effective therapy.