Proliferative glomerulonephritis with monoclonal IgG deposits in a patient with autoimmune hemolytic anemia

Clin Nephrol. 2013 Jun;79(6):494-8. doi: 10.5414/cn107267.

Abstract

A 25-year-old woman was admitted because of proteinuria. A renal biopsy showed mesangial/endocapillary proliferative glomerulonephritis with IgG2-κ deposits. Electron microscopy showed immune complex-type deposits. She also had Coombs-positive hemolytic anemia, anticardiolipin antibodies, and antinuclear antibodies. Middle-dose steroid therapy led to improvement of proteinuria and hemolytic anemia. Six years later, she developed crescentic glomerulonephritis with IgG2-κ deposits during pregnancy. Middle-dose steroid therapy improved renal dysfunction. This is an exceptional case of proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID), a recently described rare dysproteinemia-related glomerulonephritis, associated with autoimmune disease. This case also suggests that crescentic glomerulonephritis can be superimposed on PGNMID.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anemia, Hemolytic, Autoimmune / drug therapy
  • Anemia, Hemolytic, Autoimmune / immunology*
  • Anemia, Hemolytic, Autoimmune / pathology
  • Antibodies, Monoclonal / blood
  • Biomarkers / blood
  • Biopsy
  • Female
  • Follow-Up Studies
  • Glomerular Mesangium / immunology
  • Glomerulonephritis, Membranoproliferative / drug therapy
  • Glomerulonephritis, Membranoproliferative / immunology*
  • Glomerulonephritis, Membranoproliferative / pathology
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunoglobulin G / blood*
  • Immunologic Factors / blood*
  • Microscopy, Electron
  • Pregnancy
  • Pregnancy Complications, Hematologic / drug therapy
  • Pregnancy Complications, Hematologic / immunology*
  • Pregnancy Complications, Hematologic / pathology
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Biomarkers
  • Glucocorticoids
  • Immunoglobulin G
  • Immunologic Factors