Fibrillary glomerulonephritis combined with chronic inflammatory demyelinating polyneuropathy.
A 58-yr-old man presented with leg edema and subacute weakness of his bilateral lower extremities. Urinary and serum immunoelectrophoresis revealed the presence of lambda-type Bence Jones proteins. He was ultimately diagnosed with monoclonal gammopathy of undetermined significance (MGUS). A renal biopsy specimen showed fibrillary glomerulonephritis (FGN), which was randomly arranged as 12-20 m nonbranching fibrils in the basement membranes. Immunofluorescence studies were negative for immunoglobulin (Ig)G, IgM, IgA, C3, and kappa light chains in the capillary walls and mesangial areas. A Congo red stain for amyloid was negative. Electromyography and nerve conduction velocity examinations results were compatible with the presence of demyelinating polyneuropathy. This case showed a rare combination of FGN, without Ig deposition, and MGUS combined with chronic inflammatory demyelinating polyneuropathy (CIDP).
Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
Woo Kyung
WK
Sung
Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
Jin Uk
JU
Jeong
Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
Ki Tae
KT
Bang
Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
Jong Ho
JH
Shin
Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
Ji Hyung
JH
Yoo
Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
Nak Min
NM
Kim
Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
Jun Hyung
JH
Park
Department of Pathology, Eulji University School of Medicine, Daejeon, Korea.
Joo Heon
JH
Kim
Fibrillary glomerulonephritis; Monoclonal gammopathy; Polyneuropathy