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Monoclonal gammopathy associated membranous glomerulonephritis: A rare entity

K K Gowda1, K Joshi1, R Ramachandran2

  • 1Department of Histopathology, PGIMER, Chandigarh, India.

Indian Journal of Nephrology
|February 17, 2015
PubMed

Insights

A rare case of membranous glomerulonephritis (MGN) with monoclonal gammopathy was diagnosed in a 40-year-old male. Treatment with bortezomib, thalidomide, and dexamethasone led to partial remission.

Area of Science:

  • Nephrology
  • Immunopathology

Background:

  • Membranous glomerulonephritis (MGN) is a leading cause of nephrotic syndrome in adults.
  • Monoclonal gammopathy, particularly with immunoglobulin G3-kappa, is an uncommon association with MGN.

Observation:

  • A 40-year-old male presented with nephrotic syndrome and biopsy findings consistent with MGN.
  • Immunofluorescence revealed characteristic IgG3-kappa and C3 deposition along the glomerular basement membrane.
  • Electron microscopy confirmed subepithelial electron-dense deposits.

Findings:

  • The patient was diagnosed with a rare entity: MGN associated with monoclonal gammopathy.
  • Treatment involved a combination regimen of bortezomib, thalidomide, and dexamethasone.

Implications:

  • This case highlights the importance of investigating monoclonal gammopathies in patients with MGN.
  • The observed partial remission suggests potential efficacy of this treatment regimen in select cases.
  • Further research is warranted to understand the pathogenesis and optimal management of this rare condition.

Keywords:
Membranous glomerulonephritisimmunoglobulinmonoclonal gammopathy

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