{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T04:02:21Z","timestamp":1792555341083,"version":"4.5.0"},"reference-count":12,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Monoclonal gammopathy of undetermined significance (MGUS) is a benign but precancerous condition that can progress to multiple myeloma. Patients with MGUS are typically monitored closely for signs of disease progression, but in some cases, they may also develop renal insufficiency, a condition known as monoclonal gammopathy of renal significance (MGRS). In MGRS, M\u2010protein secreted by a nonmalignant or premalignant cell clone triggers renal damage by definition. Herein, we report a case of a 66\u2010year\u2010old Asian male with MGUS complicated by renal insufficiency. A kidney biopsy showed no evidence of renal injury mediated by M\u2010protein; instead, the direct infiltration of clonal cells into renal tissues was observed. Although five similar cases have been previously reported, our case is unique in that the involvement of clonal cells was directly confirmed by fluorescence in situ hybridization. Our findings suggest the need to consider a novel disease concept, as this phenomenon appears to be reproduced.<\/jats:p>","DOI":"10.1002\/jha2.747","type":"journal-article","created":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T16:38:51Z","timestamp":1687797531000},"page":"829-832","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Direct infiltration of clonal plasma cells causes renal insufficiency in patients with monoclonal gammopathy of undetermined significance"],"prefix":"10.1002","volume":"4","author":[{"given":"Ryosuke","family":"Naka","sequence":"first","affiliation":[{"name":"Department of Hematology Kobe City Hospital Organization Kobe City Medical Center General Hospital Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1018-9508","authenticated-orcid":false,"given":"Yoshimitsu","family":"Shimomura","sequence":"additional","affiliation":[{"name":"Department of Hematology Kobe City Hospital Organization Kobe City Medical Center General Hospital Kobe Japan"},{"name":"Department of Social and Environmental Medicine Graduate School of Medicine Osaka University Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madoka","family":"Kanda\u2010Kato","sequence":"additional","affiliation":[{"name":"Department of Hematology Kobe City Hospital Organization Kobe City Medical Center General Hospital Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Hiramoto","sequence":"additional","affiliation":[{"name":"Department of Hematology Kobe City Hospital Organization Kobe City Medical Center General Hospital Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeo","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Kobe City Hospital Organization Kobe City Medical Center General Hospital Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Hematology Kobe City Hospital Organization Kobe City Medical Center General Hospital Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1810907"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-019-1646-x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-017-2270-4"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.5414\/CNP65427"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004391"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2012.01.010"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2015.174"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2013.1282"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/03000605211063713"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-011-0437-x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.12.028"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-05-495929"}],"container-title":["eJHaem"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jha2.747","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T18:00:16Z","timestamp":1694714416000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jha2.747"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,26]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1002\/jha2.747"],"URL":"https:\/\/doi.org\/10.1002\/jha2.747","archive":["Portico"],"relation":{},"ISSN":["2688-6146","2688-6146"],"issn-type":[{"value":"2688-6146","type":"print"},{"value":"2688-6146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,26]]},"assertion":[{"value":"2023-06-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}