伴单克隆IgG沉积的增殖性肾小球肾炎

Proliferative Glomerulonephritis with Monoclonal IgG Deposits.

作者信息

Sakthirajan Ramanathan, Dhanapriya Jeyachandran, Dineshkumar Thanigachalam, Kawaskar Kaliyaperumal, Gopalakrishnan Natarajan, Balasubramaniyan T

机构信息

Assistant Professor,Institute of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu.

Resident, Institute of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu.

出版信息

J Assoc Physicians India. 2018 Dec;66(12):84-85.

PMID:31313561

Abstract

Proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) is a recently described disorder that belongs to the class of monoclonal gammopathy of renal significance with the incidence of 0.17%. Monoclonal IgG deposits in glomeruli can produce a proliferative glomerulonephritis that mimics immune-complex mediated glomerulonephritis by light microscopy (LM) and electron microscopy (EM). Proper recognition of this disease requires confirmation of monoclonality by immunofluorescence (IF) staining. We present here a 50 year old female patient presented with nephrotic range proteinuria and normal renal function. Renal biopsy showed endocapillary and mesangial proliferation by LM. IF showed Ig G (+2) and C3 (+2) with positivity for Lambda light chain and Kappa light chain is negative consistent with PGNMID.

摘要

伴单克隆IgG沉积的增殖性肾小球肾炎（PGNMID）是一种最近描述的疾病，属于具有肾意义的单克隆丙种球蛋白病，发病率为0.17%。肾小球中的单克隆IgG沉积可产生增殖性肾小球肾炎，通过光学显微镜（LM）和电子显微镜（EM）观察，其表现类似于免疫复合物介导的肾小球肾炎。正确识别这种疾病需要通过免疫荧光（IF）染色确认单克隆性。我们在此报告一名50岁女性患者，表现为肾病范围蛋白尿且肾功能正常。肾活检通过LM显示毛细血管内和系膜增殖。IF显示IgG（+2）和C3（+2），λ轻链阳性而κ轻链阴性，符合PGNMID。