title: Myeloperoxidase anti-cytoplasmic antibody related crescentic glomerulonephritis in a patient with IgG3λ monoclonal immunoglobulin deposition disease with membranous features.
abstract: A 68-year-old woman showed rapidly progressive glomerulonephritis based on the fact that she had 1+ proteinuria (1.1 g/day), a 3+ occult blood reaction, blood urea nitrogen of 32.4 mg/dL, serum creatinine of 2.96 mg/dL, and myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibodies (ANCA) at 52 ELISA Unit (normal range: below 10). A renal biopsy demonstrated a bubbling appearance associated with cellular crescent formation with segmental necrosis. Immunofluorescence studies showed granular IgG3λ deposition along the basement membrane and in the mesangial area. This is the first English-language case report describing MPO-ANCA positive crescentic glomerulonephritis in a patient demonstrating monoclonal immunoglobulin deposition disease with mainly membranous features.
authors.affiliation: Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Japan.
authors.forename: Ayano
authors.initials: A
authors.lastname: Ito
authors.forename: Naoto
authors.initials: N
authors.lastname: Miura
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Kimura
authors.forename: Sayaka
authors.initials: S
authors.lastname: Maeda
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.forename: Wataru
authors.initials: W
authors.lastname: Kitagawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Morita
authors.forename: Shogo
authors.initials: S
authors.lastname: Banno
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Imai
mesh_terms: D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000378:metabolism*; D001485:Basement Membrane / Q000276:immunology / Q000473:pathology*; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D005455:Fluorescent Antibody Technique; D005920:Glomerular Mesangium / Q000276:immunology / Q000473:pathology; D005921:Glomerulonephritis / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007154:Immune System Diseases / Q000150:complications* / Q000188:drug therapy / Q000276:immunology*; D007074:Immunoglobulin G / Q000378:metabolism*; D009195:Peroxidase / Q000276:immunology*; D011239:Prednisolone / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D005938:Glucocorticoids; D007074:Immunoglobulin G; D011239:Prednisolone; D009195:Peroxidase