Proliferative glomerulonephritis with monoclonal igm deposits without Waldenström's macroglobulinemia: Case report and review of the literature

Mayumi Yahata, Izaya Nakaya, Satoko Takahashi, Tsutomu Sakuma, Hiroshi Sato, Jun Soma

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

A 38-year-old man was presented with nephrotic syndrome associated with hematuria and mild hypocomplementemia. Renal biopsy revealed lobular mesangial proliferation, thickened capillary walls, and intraluminal protein thrombi. Immunofluorescence showed marked and mild depositions of immunoglobulin (Ig) M heavy chains and complement C3, respectively, in a peripheral lobular pattern. On light chain staining, only kappa (κ) light and IgM heavy chains showed a similar pattern. Electron microscopy showed fine granular electrondense deposits in subendothelial areas and numerous globular deposits (varying size and density) in glomerular capillary lumens. Serum levels of Ig κ, but not of free κ, light chains were significantly increased. Bone marrow aspiration revealed a normocellular marrow. Waldenström's macroglobulinemia and cryoglobulinemia were ruled out. Clinically, steroid therapy was ineffective and proteinuria persisted. This report demonstrates that glomerular deposition of monoclonal IgM-κ can produce membranoproliferative-like changes in the glomeruli. This condition may be recognized as proliferative glomerulonephritis with monoclonal IgM deposits similar to the recently recognized proliferative glomerulonephritis with monoclonal IgG deposits.

Original languageEnglish
Pages (from-to)254-260
Number of pages7
JournalClinical nephrology
Volume77
Issue number3
DOIs
Publication statusPublished - 2012 Mar 1

Keywords

  • Monoclonal IgG deposits
  • Monoclonal immunoglobulin deposition disease
  • Nephrotic syndrome
  • Plasma cell dysplasia

ASJC Scopus subject areas

  • Nephrology

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