Proliferative Glomerulonephritis with Monoclonal Immunoglobulin Light Chain Deposits: A Rare Entity Mimicking Immune-Complex Glomerulonephritis
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概要
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A 39-year-old man developed proteinuria, hematuria, and renal insufficiency. A renal biopsy revealed the presence of mesangial proliferative glomerulonephritis with monoclonal λ-light chain deposits without evidence of immunoglobulin G (IgG), immunoglobulin A (IgA) or immunoglobulin M (IgM) deposits. Electron microscopy revealed granular electron-dense deposits resembling immune-complex deposits. No monoclonal proteins were detected in the serum or urine. The patient was treated with an angiotensin II receptor antagonist, and his condition was almost stable during the 1-year follow-up. This case shares common pathological characteristics with the newly described entity referred to as "proliferative glomerulonephritis with monoclonal IgG deposits" in which, glomerular deposits are composed entirely of monoclonal IgG. Therefore, we term the unusual form of glomerulonephritis observed in the present case "proliferative glomerulonephritis with monoclonal immunoglobulin light chain deposits."
著者
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Nimura Takashi
Department Of Hematology Nephrology And Rheumatology Akita University Graduate School Of Medicine
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Sawada Kenichi
Department Of Hematology Nephrology And Rheumatology Akita University Graduate School Of Medicine
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Ohtani Hiroshi
Department Of Cardiology And Hematology Fukushima Medical University
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Nara Mizuho
Department Of Hematology Nephrology And Rheumatology Akita University Graduate School Of Medicine
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Komatsuda Atsushi
Department of Health and Environmental Sciences, Graduate School of Medicine Kyoto University
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Wakui Hideki
Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine
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Wakui Hideki
Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Japan
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Komatsuda Atsushi
Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Japan
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Ohtani Hiroshi
Department of Nephrology and Dialysis, Akita Kumiai General Hospital, Japan
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