{"id":"https://openalex.org/W4397044731","doi":"https://doi.org/10.1681/asn.20233411s1786b","title":"Monoclonal Gammopathy of Renal Significance (MGRS): An Alternative Pathway to C3 Glomerulonephritis (C3GN)","display_name":"Monoclonal Gammopathy of Renal Significance (MGRS): An Alternative Pathway to C3 Glomerulonephritis (C3GN)","publication_year":2023,"publication_date":"2023-11-01","ids":{"openalex":"https://openalex.org/W4397044731","doi":"https://doi.org/10.1681/asn.20233411s1786b"},"language":"en","primary_location":{"id":"doi:10.1681/asn.20233411s1786b","doi":"https://doi.org/10.1681/asn.20233411s1786b","is_oa":false,"landing_page_url":"https://doi.org/10.1681/asn.20233411s1786b","pdf_url":null,"source":{"id":"https://openalex.org/S115693375","display_name":"Journal of the American Society of Nephrology","issn_l":"1046-6673","issn":["1046-6673","1533-3450"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315620","host_organization_name":"American Society of Nephrology","host_organization_lineage":["https://openalex.org/P4310315620"],"host_organization_lineage_names":["American Society of Nephrology"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Society of Nephrology","raw_type":"journal-article"},"volume":null,"type":"conference-abstract","is_traditional":false,"indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":null,"display_name":"Eric Magliulo","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I59130452","display_name":"University of Nebraska Medical Center","ror":"https://ror.org/00thqtb16","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I59130452"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Eric Magliulo","raw_affiliation_strings":["University of Nebraska Medical Center, Omaha, NE"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Nebraska Medical Center, Omaha, NE","institution_ids":["https://openalex.org/I59130452"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5037832098","display_name":"Saher Aslam","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I59130452","display_name":"University of Nebraska Medical Center","ror":"https://ror.org/00thqtb16","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I59130452"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Saher Aslam","raw_affiliation_strings":["University of Nebraska Medical Center, Omaha, NE"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Nebraska Medical Center, Omaha, NE","institution_ids":["https://openalex.org/I59130452"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5051001649","display_name":"Kirk W. Foster","orcid":"https://orcid.org/0000-0003-0616-2679","observed_orcids":["https://orcid.org/0000-0003-0616-2679"]},"institutions":[{"id":"https://openalex.org/I59130452","display_name":"University of Nebraska Medical Center","ror":"https://ror.org/00thqtb16","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I59130452"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Kirk W. Foster","raw_affiliation_strings":["University of Nebraska Medical Center, Omaha, NE"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Nebraska Medical Center, Omaha, NE","institution_ids":["https://openalex.org/I59130452"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5016451091","display_name":"Prasanth Ravipati","orcid":"https://orcid.org/0000-0002-4184-941X","observed_orcids":["https://orcid.org/0000-0002-4184-941X"]},"institutions":[{"id":"https://openalex.org/I59130452","display_name":"University of Nebraska Medical Center","ror":"https://ror.org/00thqtb16","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I59130452"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Prasanth Ravipati","raw_affiliation_strings":["University of Nebraska Medical Center, Omaha, NE"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Nebraska Medical Center, Omaha, NE","institution_ids":["https://openalex.org/I59130452"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5015907540","display_name":"Felipe S. Naranjo","orcid":"https://orcid.org/0000-0002-5093-5424","observed_orcids":["https://orcid.org/0000-0002-5093-5424"]},"institutions":[{"id":"https://openalex.org/I59130452","display_name":"University of Nebraska Medical Center","ror":"https://ror.org/00thqtb16","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I59130452"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Felipe S. Naranjo","raw_affiliation_strings":["University of Nebraska Medical Center, Omaha, NE"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Nebraska Medical Center, Omaha, NE","institution_ids":["https://openalex.org/I59130452"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I59130452"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":"34","issue":"11S","first_page":"786","last_page":"786"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11029","display_name":"Renal Diseases and Glomerulopathies","score":0.7080000042915344,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11029","display_name":"Renal Diseases and Glomerulopathies","score":0.7080000042915344,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10993","display_name":"Complement system in diseases","score":0.2612000107765198,"subfield":{"id":"https://openalex.org/subfields/2403","display_name":"Immunology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10649","display_name":"Multiple Myeloma Research and Treatments","score":0.009800000116229057,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/monoclonal-gammopathy-of-renal-significance","display_name":"monoclonal gammopathy of renal significance","score":0.9610000252723694},{"id":"https://openalex.org/keywords/c3-glomerulonephritis","display_name":"C3 glomerulonephritis","score":0.9980000257492065},{"id":"https://openalex.org/keywords/alternative-complement-pathway","display_name":"alternative complement pathway","score":0.8870000243186951},{"id":"https://openalex.org/keywords/complement-dysregulation","display_name":"complement dysregulation","score":0.9190000295639038},{"id":"https://openalex.org/keywords/monoclonal-paraprotein","display_name":"monoclonal paraprotein","score":0.8560000061988831},{"id":"https://openalex.org/keywords/acute-kidney-injury","display_name":"acute kidney injury","score":0.7689999938011169},{"id":"https://openalex.org/keywords/crescentic-glomerulonephritis","display_name":"crescentic glomerulonephritis","score":0.9340000152587891},{"id":"https://openalex.org/keywords/dysmorphic-red-blood-cells","display_name":"dysmorphic red blood cells","score":0.8889999985694885},{"id":"https://openalex.org/keywords/bortezomib","display_name":"bortezomib","score":0.8450000286102295},{"id":"https://openalex.org/keywords/plasmacytosis","display_name":"plasmacytosis","score":0.7210000157356262},{"id":"https://openalex.org/keywords/elderly-patients","display_name":"elderly patients","score":0.6740000247955322}],"concepts":[{"id":"https://openalex.org/C2778112473","wikidata":"https://www.wikidata.org/wiki/Q4301818","display_name":"Monoclonal gammopathy","level":5,"score":0.787574291229248},{"id":"https://openalex.org/C2780368995","wikidata":"https://www.wikidata.org/wiki/Q605006","display_name":"Glomerulonephritis","level":3,"score":0.6827666759490967},{"id":"https://openalex.org/C2777250017","wikidata":"https://www.wikidata.org/wiki/Q458138","display_name":"Monoclonal gammopathy of undetermined significance","level":5,"score":0.6413052082061768},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6284434795379639},{"id":"https://openalex.org/C163864487","wikidata":"https://www.wikidata.org/wiki/Q6901461","display_name":"Monoclonal","level":4,"score":0.4351840913295746},{"id":"https://openalex.org/C2909682104","wikidata":"https://www.wikidata.org/wiki/Q4301818","display_name":"Paraproteinemias","level":5,"score":0.4114558696746826},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.3451048731803894},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.3379269242286682},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.31101638078689575},{"id":"https://openalex.org/C542903549","wikidata":"https://www.wikidata.org/wiki/Q422248","display_name":"Monoclonal antibody","level":3,"score":0.2755074203014374},{"id":"https://openalex.org/C2780091579","wikidata":"https://www.wikidata.org/wiki/Q9377","display_name":"Kidney","level":2,"score":0.26629483699798584},{"id":"https://openalex.org/C159654299","wikidata":"https://www.wikidata.org/wiki/Q79460","display_name":"Antibody","level":2,"score":0.10744157433509827}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1681/asn.20233411s1786b","doi":"https://doi.org/10.1681/asn.20233411s1786b","is_oa":false,"landing_page_url":"https://doi.org/10.1681/asn.20233411s1786b","pdf_url":null,"source":{"id":"https://openalex.org/S115693375","display_name":"Journal of the American Society of Nephrology","issn_l":"1046-6673","issn":["1046-6673","1533-3450"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315620","host_organization_name":"American Society of Nephrology","host_organization_lineage":["https://openalex.org/P4310315620"],"host_organization_lineage_names":["American Society of Nephrology"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Society of Nephrology","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9922999739646912,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4415434675","https://openalex.org/W2523069877","https://openalex.org/W4396998771","https://openalex.org/W4399749711","https://openalex.org/W2093780976","https://openalex.org/W7106681859","https://openalex.org/W4386268178","https://openalex.org/W4397041448","https://openalex.org/W2800809683","https://openalex.org/W2807401917"],"abstract_inverted_index":{"Introduction:":[0],"C3":[1,200],"glomerulonephritis":[2,203],"(C3GN)":[3],"is":[4,14,292],"characterized":[5],"by":[6,17,294],"dysregulation":[7,37,287],"of":[8,35,59,118,246,257,275,288],"the":[9,32,255,289,302,323],"alternative":[10,290],"complement":[11,36],"pathway":[12,291],"and":[13,62,126,146,207,231,238],"commonly":[15],"accompanied":[16],"a":[18,55,68,73,87,107,116,127,181,194,199,220,243,268,273,295,311],"monoclonal":[19,182,229,278,296],"gammopathy":[20,230],"in":[21,38,109,152,250,284,309],"older":[22],"patients.":[23],"These":[24],"associated":[25],"paraproteins":[26],"are":[27],"now":[28],"increasingly":[29],"recognized":[30],"as":[31],"underlying":[33,303,324],"drivers":[34],"many":[39,285],"cases,":[40,286],"which":[41,167,197],"has":[42,306],"important":[43],"implications":[44],"regarding":[45],"treatment.":[46],"Case":[47],"Description:":[48],"An":[49],"86":[50],"year":[51],"old":[52],"male":[53],"with":[54,67,86,150,159,204,219,226,228,236,277],"past":[56],"medical":[57],"history":[58],"atrial":[60,84],"fibrillation":[61,85],"congestive":[63],"heart":[64],"failure":[65],"presented":[66],"ground":[69],"level":[70],"fall,":[71],"sustaining":[72],"small":[74],"subdural":[75],"hematoma.":[76],"On":[77],"arrival,":[78],"he":[79],"was":[80,96,133,139,155,165,177,224,232],"hypotensive":[81],"secondary":[82],"to":[83,99,112,130,141,157,192,266,272,319],"slow":[88],"ventricular":[89],"response":[90],"requiring":[91],"an":[92,251],"implantable":[93],"pacemaker.":[94],"He":[95,138,223],"hypoxic":[97],"due":[98],"pulmonary":[100],"edema":[101],"seen":[102],"on":[103,187,234,260],"imaging.":[104],"Labs":[105],"showed":[106,123,217],"rise":[108],"serum":[110],"creatinine":[111,131],"3.89":[113],"mg/dl":[114],"from":[115],"baseline":[117],"1.0":[119],"mg/dl.":[120],"Urine":[121],"dipstick":[122],"3+":[124],"hematuria":[125],"urine":[128,163,261],"protein":[129],"ratio":[132],"measured":[134],"at":[135],"2":[136],"g/g.":[137],"presumed":[140],"have":[142],"acute":[143,247],"tubular":[144],"injury":[145,249],"received":[147],"intravenous":[148],"diuretics":[149],"improvement":[151],"hypoxia.":[153],"Nephrology":[154],"consulted":[156],"assist":[158],"diuretic":[160],"management.":[161],"Manual":[162],"microscopy":[164,262],"performed":[166],"revealed":[168,198],"numerous":[169],"dysmorphic":[170,258],"red":[171],"blood":[172],"cells":[173],"(RBCs).":[174],"Serologic":[175],"testing":[176],"unremarkable":[178],"except":[179],"for":[180],"IgG":[183],"kappa":[184],"paraprotein":[185],"identified":[186],"immunofixation.":[188],"We":[189,241],"ultimately":[190],"decided":[191],"pursue":[193,267,320],"kidney":[195,248,269],"biopsy":[196,216],"dominant":[201],"crescentic":[202],"mesangial":[205,209],"proliferation":[206],"rare":[208],"electron":[210],"dense":[211],"deposits.":[212],"The":[213],"bone":[214],"marrow":[215],"hypercellularity":[218],"polyclonal":[221],"plasmacytosis.":[222],"diagnosed":[225],"C3GN":[227,276],"started":[233],"treatment":[235,299,321],"bortezomib":[237],"steroids.":[239],"Discussion:":[240],"present":[242],"challenging":[244],"case":[245],"elderly":[252],"male.":[253],"Ultimately,":[254],"finding":[256],"RBCs":[259],"informed":[263],"our":[264],"decision":[265],"biopsy,":[270],"leading":[271],"diagnosis":[274],"gammopathy.":[279],"Recent":[280],"evidence":[281],"suggests":[282],"that":[283],"driven":[293],"paraprotein.":[297],"Furthermore,":[298],"directed":[300],"towards":[301],"hematologic":[304,325],"disease":[305],"shown":[307],"promise":[308],"achieving":[310],"renal":[312],"response.":[313],"For":[314],"this":[315],"reason,":[316],"we":[317],"elected":[318],"targeting":[322],"disorder.":[326]},"counts_by_year":[],"updated_date":"2026-09-29T14:09:16.559479","created_date":"2024-05-19T00:00:00"}