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Proliferative Glomerulonephritis with Monoclonal IgG Deposits
Ramanathan Sakthirajan1, Jeyachandran Dhanapriya1, Thanigachalam Dineshkumar1
1Assistant Professor,Institute of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu.
The Journal of the Association of Physicians of India
|July 18, 2019
Summary
Proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) is a rare kidney disease. Diagnosis requires immunofluorescence to confirm monoclonal IgG deposits, mimicking other glomerulonephritis types.
Area of Science:
- Nephrology
- Pathology
- Immunology
Background:
- Proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) is a rare kidney disease, accounting for 0.17% of cases.
- It is classified under monoclonal gammopathy of renal significance.
- PGNMID can mimic immune-complex mediated glomerulonephritis on light and electron microscopy.
Observation:
- A 50-year-old female presented with nephrotic-range proteinuria and normal renal function.
- Renal biopsy revealed endocapillary and mesangial proliferation.
- Immunofluorescence showed IgG and C3 deposits, with lambda light chain positivity and negative kappa light chain.
Findings:
- The findings are consistent with a diagnosis of PGNMID.
- Monoclonality of IgG deposits was confirmed by immunofluorescence.
- The case highlights the diagnostic challenge due to morphological similarities with other glomerulonephritis.
Implications:
- Accurate diagnosis of PGNMID is crucial for appropriate patient management.
- Immunofluorescence staining is essential for differentiating PGNMID from other glomerulonephritides.
- This case contributes to understanding the clinical and pathological spectrum of PGNMID.
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