title: Post-infectious Proliferative Glomerulonephritis with Monoclonal Immunoglobulin G Deposits Associated with Complement Factor H Mutation.
abstract: A 55-year-old man developed rapidly progressive glomerulonephritis and nephrotic syndrome. A kidney biopsy specimen showed diffuse proliferative and crescentic glomerulonephritis with monoclonal IgG1κ, humps, and nephritis-associated plasmin receptor, indicating infection-associated proliferative glomerulonephritis with monoclonal immunoglobulin G deposits (PGNMID). Despite dialysis-dependent renal failure, symptomatic therapy resulted in spontaneous recovery of the renal function, mimicking post-infectious glomerulonephritis (PIGN). A heterozygous complement factor H mutation was detected by comprehensive genetic testing of alternative pathway regulatory genes, which might lead to persistent infection-triggered alternative pathway activation and account for severe glomerulonephritis. Post-infectious PGNMID and PIGN might share common clinical presentations and pathogenesis related to the complement pathway.
authors.affiliation: Department of Nephrology, Shuuwa General Hospital, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Takehara
authors.forename: Shintaro
authors.initials: S
authors.lastname: Mandai
authors.forename: Satomi
authors.initials: S
authors.lastname: Shikuma
authors.forename: Wataru
authors.initials: W
authors.lastname: Akita
authors.forename: Motoko
authors.initials: M
authors.lastname: Chiga
authors.forename: Takayasu
authors.initials: T
authors.lastname: Mori
authors.forename: Takashi
authors.initials: T
authors.lastname: Oda
authors.forename: Michio
authors.initials: M
authors.lastname: Kuwahara
authors.forename: Shinichi
authors.initials: S
authors.lastname: Uchida
mesh_terms: D017242:Complement Factor H / Q000235:genetics; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D018000:Receptors, Peptide / Q000378:metabolism; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000503:physiopathology
chemical_list: C493495:CFH protein, human; D007074:Immunoglobulin G; D018000:Receptors, Peptide; C065181:plasmin receptor; D017242:Complement Factor H