Recurrence of Proliferative Glomerulonephritis with Monoclonal Immunoglobulin G Deposits with a Striated Ultrastructure

Namba, Tomoko; Hamano, Takayuki; Imamura, Ryoichi; Yamaguchi, Yutaka; Kyo, Masahiro; Yonishi, Hiroaki; Takahashi, Atsushi; Kawamura, Masataka; Nakazawa, Shigeaki; Kato, Taigo; Abe, Toyofumi; Kyakuno, Miyaji; Takabatake, Yoshitsugu; Nonomura, Norio; Isaka, Yoshitaka

doi:https://doi.org/10.1159/000512330

Recurrence of Proliferative Glomerulonephritis with Monoclonal Immunoglobulin G Deposits with a Striated Ultrastructure

Namba, Tomoko; Hamano, Takayuki; Imamura, Ryoichi et al.

Nephron, 2020, 144(Suppl. 1), 43-48

Number of Access:2,534（2025-07-16 18:31 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/78281

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Title	Recurrence of Proliferative Glomerulonephritis with Monoclonal Immunoglobulin G Deposits with a Striated Ultrastructure
Creator	NRID 1000030734420 1000030734420 researchmap permalink namba-handai3857 namba-handai3857 Scopus Author ID 8577526800 8577526800 CreatorName Namba, Tomoko Creator.Alternative Hamano, Tomoko
	NRID 1000050403077 1000050403077 CreatorName Hamano, Takayuki
	CreatorName Imamura, Ryoichi
	CreatorName Yamaguchi, Yutaka
	CreatorName Kyo, Masahiro
	NRID 1000040822143 1000040822143 CreatorName Yonishi, Hiroaki
	NRID 1000010704786 1000010704786 researchmap permalink takahashi-handai3857 takahashi-handai3857 Scopus Author ID 55728349700 55728349700 CreatorName Takahashi, Atsushi
	CreatorName Kawamura, Masataka
	NRID 1000080759530 1000080759530 ORCID 0000-0001-5857-3483 0000-0001-5857-3483 researchmap permalink snakazawa snakazawa Scopus Author ID 36350232600 36350232600 CreatorName Nakazawa, Shigeaki
	NRID 1000070648021 1000070648021 researchmap permalink taigokato taigokato Scopus Author ID 55414697500 55414697500 CreatorName Kato, Taigo
	NRID 1000090750894 1000090750894 CreatorName Abe, Toyofumi
	CreatorName Kyakuno, Miyaji
	NRID 1000030403075 1000030403075 CreatorName Takabatake, Yoshitsugu
	NRID 1000030263263 1000030263263 researchmap permalink read0185096 read0185096 Scopus Author ID 7005880662 7005880662 CreatorName Nonomura, Norio
	NRID 1000000379166 1000000379166 researchmap permalink isaka-handai3857 isaka-handai3857 Scopus Author ID 16207611100 16207611100 ORCID 0000-0002-0820-7167 0000-0002-0820-7167 CreatorName Isaka, Yoshitaka
Subject	Membranoproliferative glomerulonephritis
	Proliferative glomerulonephritis with monoclonal IgG deposits
	Recurrent glomerular disease
	Renal transplantation
	Striated structure
Description	This is the peer-reviewed but unedited manuscript version of the following article: Nephron 2020;144(suppl 1):43–48 (DOI: 10.1159/000512330)]. The final, published version is available at http://www.karger.com/?doi=10.1159/000512330.
Abstract	A 64-year-old man with nephrotic syndrome was admitted to another hospital where his renal biopsy revealed membranoproliferative glomerulonephritis (MPGN) with monoclonal immunoglobulin (Ig) G, subclass 1, κ light chain (IgG1κ) deposition on immunofluorescence (IF). Proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) was suspected due to monoclonal IgG1κ deposits and the absence of hematological abnormalities. However, the typical PGNMID phenotype was not observed by electron microscopy. Instead, an organized and striated muscle-like structure was observed in the subendothelial space. Since a 2-year treatment with immunosuppressants did not improve his proteinuria, a second biopsy was performed at our hospital. It showed an MPGN-like phenotype; however, monoclonal Ig deposits on IF were no longer observed. One year after the second biopsy, he developed ESRD. Thus, he underwent living kidney transplantation from his wife. Allograft biopsy was performed as proteinuria was observed 3 months after transplantation, which again showed an MPGN-like phenotype with monoclonal IgG1κ deposits. The observed electron-dense deposits were similar to those in the native biopsies. Accordingly, the patient was diagnosed with recurrent MPGN. Adding methylprednisolone pulse therapy to conventional immunosuppressants did not improve the patient's renal function or proteinuria. He died of Legionella pneumonia 8 months after transplantation. Considering the patient's histological findings of MPGN with monoclonal IgG1κ deposits and early recurrence of glomerulonephritis after transplantation, he was diagnosed with PGNMID with novel electron-dense deposits.
Publisher	S. Karger AG
Source Title	Nephron
Volume (Issue)	144(Suppl. 1)
Page	43-48
Date of Issued	2020
Language	English
Handle URL	https://hdl.handle.net/11094/78281
PISSN	16608151
eISSN	22353186
NCID	AA1278405X
Relation.isVersionOf	DOI (Publisher Version) https://doi.org/10.1159/000512330
Relation.isIdenticalTo	PMID 33227797
Access Rights	open access
oaire:version	Accepted Manuscript
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Nephron. 2020, 144(Suppl. 1), p. 43-48
DC.title	Recurrence of Proliferative Glomerulonephritis with Monoclonal Immunoglobulin G Deposits with a Striated Ultrastructure
DC.creator	Namba, Tomoko
	Hamano, Takayuki
	Imamura, Ryoichi
	Yamaguchi, Yutaka
	Kyo, Masahiro
	Yonishi, Hiroaki
	Takahashi, Atsushi
	Kawamura, Masataka
	Nakazawa, Shigeaki
	Kato, Taigo
	Abe, Toyofumi
	Kyakuno, Miyaji
	Takabatake, Yoshitsugu
	Nonomura, Norio
	Isaka, Yoshitaka
DC.creator	Hamano, Tomoko
DC.publisher	S. Karger AG
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2020
DC.identifier	https://doi.org/10.1159/000512330
DC.subject	Membranoproliferative glomerulonephritis
	Proliferative glomerulonephritis with monoclonal IgG deposits
	Recurrent glomerular disease
	Renal transplantation
	Striated structure
DC.description	This is the peer-reviewed but unedited manuscript version of the following article: Nephron 2020;144(suppl 1):43–48 (DOI: 10.1159/000512330)]. The final, published version is available at http://www.karger.com/?doi=10.1159/000512330.
DCTERMS.abstract	A 64-year-old man with nephrotic syndrome was admitted to another hospital where his renal biopsy revealed membranoproliferative glomerulonephritis (MPGN) with monoclonal immunoglobulin (Ig) G, subclass 1, κ light chain (IgG1κ) deposition on immunofluorescence (IF). Proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) was suspected due to monoclonal IgG1κ deposits and the absence of hematological abnormalities. However, the typical PGNMID phenotype was not observed by electron microscopy. Instead, an organized and striated muscle-like structure was observed in the subendothelial space. Since a 2-year treatment with immunosuppressants did not improve his proteinuria, a second biopsy was performed at our hospital. It showed an MPGN-like phenotype; however, monoclonal Ig deposits on IF were no longer observed. One year after the second biopsy, he developed ESRD. Thus, he underwent living kidney transplantation from his wife. Allograft biopsy was performed as proteinuria was observed 3 months after transplantation, which again showed an MPGN-like phenotype with monoclonal IgG1κ deposits. The observed electron-dense deposits were similar to those in the native biopsies. Accordingly, the patient was diagnosed with recurrent MPGN. Adding methylprednisolone pulse therapy to conventional immunosuppressants did not improve the patient's renal function or proteinuria. He died of Legionella pneumonia 8 months after transplantation. Considering the patient's histological findings of MPGN with monoclonal IgG1κ deposits and early recurrence of glomerulonephritis after transplantation, he was diagnosed with PGNMID with novel electron-dense deposits.
DC.format	78281
citation_title	Recurrence of Proliferative Glomerulonephritis with Monoclonal Immunoglobulin G Deposits with a Striated Ultrastructure
citation_author	Namba, Tomoko
	Hamano, Takayuki
	Imamura, Ryoichi
	Yamaguchi, Yutaka
	Kyo, Masahiro
	Yonishi, Hiroaki
	Takahashi, Atsushi
	Kawamura, Masataka
	Nakazawa, Shigeaki
	Kato, Taigo
	Abe, Toyofumi
	Kyakuno, Miyaji
	Takabatake, Yoshitsugu
	Nonomura, Norio
	Isaka, Yoshitaka
citation_publisher	S. Karger AG
citation_language	English
citation_date	2020
citation_journal_title	Nephron
citation_volume	144
citation_issue	Suppl. 1
citation_firstpage	43
citation_lastpage	48
citation_doi	https://doi.org/10.1159/000512330
citation_pmid	33227797
citation_public_url	https://hdl.handle.net/11094/78281

Recurrence of Proliferative Glomerulonephritis with Monoclonal Immunoglobulin G Deposits with a Striated Ultrastructure

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