What is your approach to the treatment of fibrillary glomerulonephritis coexistent with monoclonal gammopathy?  

Fibrillary glomerulonephritis was initially considered to be an idiopathic disorder, but it is now known to be secondary to malignancy, monoclonal gammopathy, infection (such as HCV), or autoimmune disease in up to 50% of patients. This is a rare disease, and few practitioners outside of glomer...