An IgA1-lambda-type monoclonal immunoglobulin deposition disease associated with membranous features in a patient with chronic hepatitis C viral infection and rectal cancer.
A 61-year-old man infected with hepatitis C virus developed urinary protein. Two-dimensional electrophoresis and immunoblotting of sera revealed no monoclonal proteins. Light microscopy and immunofluorescence of a kidney biopsy specimen demonstrated bubbling appearance and formation of spikes, associated with predominantly IgA1-lambda deposition, but not IgG, along glomerular capillary walls. Electron microscopy showed electron-dense deposits without any fibrillary structure located in the glomerular basement membrane. Seven months after the kidney biopsy, the patient had a surgical operation for rectal cancer. One year later, the urinary protein was still present. The present case is the first report of an IgA1-lambda-type monoclonal immunoglobulin deposition disease associated with membranous features.
Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute-cyo, Aichi, 480-1195, Japan.
Naoto
N
Miura
Yuko
Y
Uemura
Natsuko
N
Suzuki
Norihiro
N
Suga
Kunihiro
K
Maeda
Satoshi
S
Yamaguchi
Wataru
W
Kitagawa
Harutaka
H
Yamada
Kazuhiro
K
Nishikawa
Hirokazu
H
Imai
D000230:Adenocarcinoma / Q000150:complications* / Q000276:immunology; D015433:Glomerulonephritis, Membranous / Q000150:complications / Q000276:immunology*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007146:Immunoglobulin lambda-Chains / Q000276:immunology; D008297:Male; D011507:Proteinuria / Q000276:immunology; D012004:Rectal Neoplasms / Q000150:complications* / Q000276:immunology
D007070:Immunoglobulin A; D007146:Immunoglobulin lambda-Chains