Chronological change of renal pathological findings in the proliferative glomerulonephritis with monoclonal IgG deposits considered to have recurred early after kidney transplantation

CEN Case Reports
Takayuki KatsunoShoichi Maruyama

Abstract

Proliferative glomerulonephritis with monoclonal immunoglobulin G (IgG) deposits (PGNMID) is a rare disease that recently became recognized. Its pathological findings are characterized by the deposition of a single heavy chain subclass and a single light chain isotype. PGNMID has been proven to recur in renal allografts. Herein, the authors describe the case of a 46-year-old man who presented with nephrotic syndrome and progressive kidney injury following kidney transplantation. One month after transplantation, his clinical condition stabilized; however, the protocol biopsy showed depositions of IgG and complement on the glomeruli by immunofluorescence staining. Electron microscopy (EM) revealed granular electron-dense deposits (EDD) in the mesangium. Thereafter, renal biopsy was repeated because his proteinuria level increased. Proliferative glomerulonephritis, mainly in the mesangium, with IgG and complement deposits and mesangial and subendothelial EDD were observed; however, the pathological diagnosis was difficult. Renal dysfunction then became apparent, and renal biopsy was performed again 4 years and 10 months after kidney transplantation. Glomerular deposits on a single IgG subclass and a single light chain isotype (IgG...Continue Reading

References

May 28, 2009·Journal of the American Society of Nephrology : JASN·Samih H NasrVivette D D'Agati
Oct 31, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Claudio Ponticelli
Sep 30, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Samih H NasrVivette D D'Agati
Jun 28, 2011·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Alia AlbawardiTibor Nadasdy
Jan 22, 2015·Kidney International·Frank BridouxUNKNOWN International Kidney and Monoclonal Gammopathy Research Group
Apr 4, 2015·Indian Journal of Nephrology·K K GowdaM Sachdeva
Jul 20, 2016·Journal of the American Society of Nephrology : JASN·Michelle M O'ShaughnessyWolfgang C Winkelmayer
Sep 28, 2017·Nefrología : publicación oficial de la Sociedad Española Nefrologia·Fernando Caravaca-FontánManuel Praga

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Citations

Feb 28, 2020·Annals of Hematology·Chao ZuoGaosi Xu
Oct 13, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Paul MillerMegan L Troxell

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