Proliferative Glomerulonephritis With Monoclonal IgG Deposits in a Young Patient: A Case Report

Lara El Khoury, Suzanne El Sayegh, Theodore Strange, Elie El Charabaty, Talal El Imad

Abstract


Proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) is a newly described entity that belongs to the class of disorders known as monoclonal gammopathy of renal significance (MGRS). The renal deposit in PGNMID is composed of monoclonal immunoglobulin (Ig). Microscopic findings typically show a non-fibrillar or non-microtubular pattern of Ig deposit without any organized structure. This entity affects adults and most patients present with nephrotic-range proteinuria and hematuria with or without renal failure. We report a unique case of PGNMID occurring in a young patient following a viral infection. The patient had significant proteinuria. There were no monoclonal proteins found in the serum. The renal biopsy was consistent with proliferative glomerulonephritis (GN) with monoclonal immune deposits. PGNMID is a novel form of GN that mimics immune-complex type GN on light and electron microscopy; thus, renal biopsy with careful attention to light-chain and IgG isotype staining is essential for diagnosis.




J Med Cases. 2016;7(5):191-194
doi: http://dx.doi.org/10.14740/jmc2444w

Keywords


Monoclonal immune deposits; Proliferative glomerulonephritis; Immunofluorescence

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