title: Proliferative glomerulonephritis with monoclonal IgG deposits in a patient with autoimmune hemolytic anemia.
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.
authors.affiliation: Department of Hematology, Nephrology, and Rheumatology, Akita, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Atsushi
authors.initials: A
authors.lastname: Komatsuda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohtani
authors.forename: Masaru
authors.initials: M
authors.lastname: Togashi
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Sawada
authors.forename: Hideki
authors.initials: H
authors.lastname: Wakui
mesh_terms: D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D000911:Antibodies, Monoclonal / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D005920:Glomerular Mesangium / Q000276:immunology; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007155:Immunologic Factors / Q000097:blood*; D008854:Microscopy, Electron; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D015415:Biomarkers; D005938:Glucocorticoids; D007074:Immunoglobulin G; D007155:Immunologic Factors