Journal
HUMAN PATHOLOGY
Volume 43, Issue 12, Pages 2326-2333Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.humpath.2012.04.004
Keywords
IgG kappa; Monoclonal immunoglobulin; Parvovirus B19; Postinfectious glomerulonephritis; Proliferative glomerulonephritis with monoclonal IgG deposits
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Funding
- Japanese Society for the Promotion of Science [23790964]
- Grants-in-Aid for Scientific Research [23790964] Funding Source: KAKEN
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Proliferative glomerulonephritis with monoclonal immunoglobulin G deposits is a recently described disease entity, characterized by nonorganized electron-dense deposits in glomeruli and immunofluorescence findings indicating monoclonal immunoglobulin G deposits. The pathogenesis of many cases of proliferative glomerulonephritis with monoclonal immunoglobulin G deposits remains unknown. We herein report 2 patients with parvovirus B19 infection who developed acute nephritic syndrome with hypocomplementemia (patient 1) or persistent proteinuria and congestive heart failure (patient 2); however, neither patient had detectable levels of scrum monoclonal immunoglobulin G. Renal biopsy in both patients showed diffuse endocapillary proliferative glomerulonephritis with monoclonal immunoglobulin G3 kappa deposits, and electron microscopy showed nonorganized electron-dense deposits mainly in the subendothelial and mesangial areas. Clinical symptoms, abnormal laboratory findings, and urinary abnormalities recovered spontaneously in both cases within 4 weeks. Our 2 cases may be the first reported patients with proliferative glomerulonephritis with monoclonal immunoglobulin G deposits possibly associated with parvovirus B19 infection. Virus infection associated immune disorders could be implicated in the pathogenesis of proliferative glomerulonephritis with monoclonal immunoglobulin G deposits. (C) 2012 Elsevier Inc. All rights reserved.
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