Glomerulonephritis with predominant paramesangial IgG deposition

The new clinicopathological entity, immunoglobin G (IgG)-associated mesangial proliferative glomerulonephritis (GN), has been reported recently, but serial renal biopsies were not performed in the cases reported. The findings of three serial renal biopsies in a pediatric case with IgG-associated GN and paramesangial deposits are reported. Microscopic hematuria was found incidentally at the age of 8 years and the hematuria often worsened transiently during periods of upper respiratory infections. The patient was treated mainly with dipyridamole. The third biopsy showed that both paramesangial hemispherical deposits and predominant mesangial IgG deposits had increased, while mesangial cell proliferation had markedly decreased. These serial biopsy findings suggest that IgG-associated GN with microscopic hematuria and slight proteinuria may be characterized by a relatively benign histological and clinical course, as described in recent reports.