title: Proliferative glomerulonephritis with monoclonal immunoglobulin light chain deposits: a rare entity mimicking immune-complex glomerulonephritis.
abstract: 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."
authors.affiliation: Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Japan. komatsud@med.akita-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Komatsuda
authors.forename: Mizuho
authors.initials: M
authors.lastname: Nara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohtani
authors.forename: Takashi
authors.initials: T
authors.lastname: Nimura
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sawada
authors.forename: Hideki
authors.initials: H
authors.lastname: Wakui
mesh_terms: D000328:Adult; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005921:Glomerulonephritis / Q000175:diagnosis* / Q000276:immunology*; D015432:Glomerulonephritis, Membranoproliferative / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007105:Immune Complex Diseases / Q000175:diagnosis* / Q000276:immunology*; D007074:Immunoglobulin G / Q000378:metabolism; D007147:Immunoglobulin Light Chains / Q000378:metabolism*; D008297:Male; D050527:Mesangial Cells / Q000276:immunology / Q000648:ultrastructure; D010265:Paraproteinemias / Q000175:diagnosis* / Q000276:immunology* / Q000473:pathology
chemical_list: D057911:Angiotensin Receptor Antagonists; D007074:Immunoglobulin G; D007147:Immunoglobulin Light Chains