Rollino C, Coppo R, Mazzucco G, Roccatello D, Amore A, Basolo B, Martina G, Gianoglio B, Piccoli G
Institute of Nephro-Urology, University of Turin, Italy.
Am J Kidney Dis. 1990 Mar;15(3):276-80. doi: 10.1016/s0272-6386(12)80775-x.
We report a case with IgG-kappa monoclonal gammopathy of unidentified significance (MGUS) and glomerulonephritis (GN) with organized microtubular deposits on electron microscopy (EM). Light microscopy (LM) examination showed exudative features and moderate extracapillary proliferation. An acute nephritic syndrome with a rapidly progressive renal failure was clinically manifest at the onset and during each relapse. The patient was treated with methylprednisolone pulses followed by oral prednisone, cyclophosphamide, plasmapheresis, and maintenance courses of chemotherapy. The response to treatment was good, with a temporary improvement of renal function and control of the downhill course over a 3-year follow-up.
我们报告一例具有意义未明的IgG-κ单克隆丙种球蛋白病（MGUS）和肾小球肾炎（GN）的病例，电镜检查发现有组织化的微管沉积物。光镜（LM）检查显示渗出性特征和中度的毛细血管外增生。临床上起病时及每次复发时均表现为急性肾炎综合征伴快速进展的肾衰竭。患者接受了甲泼尼龙冲击治疗，随后口服泼尼松、环磷酰胺、血浆置换及化疗维持疗程。治疗反应良好，在3年的随访中肾功能暂时改善，病情的恶化进程得到控制。
