[Fibrillary glomerulonephritis of the nodular glomerulosclerosis variety]

We report a 63 years old female patient presenting with progressive edema, alopecia and pallor. Laboratory showed a proteinuria of 1.9 g/24 h, microhematuria, a serum creatinine of 3.1 mg/dl, erythrocyte sedimentation rate of 133 mm/h and antinuclear antibodies of 1/40 with a homogeneous pattern. No extrarenal disease was demonstrated and a kidney biopsy, performed 18 months later, showed a fibrillary glomerulonephritis, nodular sclerosis variety, with 20 nm phi fibrillae, immune and kappa and lambda light chain deposits and negative Congo red stain. The patient died 30 months later due to a respiratory infection. Fibrillary glomerulonephritis is an infrequent form of mesangiocapillary glomerulonephritis not associated to plasma cell dyscrasia. It leads to terminal renal failure and it recurs in transplanted kidneys.