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Discussion The clinical picture was suggestive of cryoglobulinaemia although cryoglobulins were detected only once; in fact there is generally no relationship between the severity of vasculitic manifestations and serum levels of cryoglobulins or complements (1). In our case the diagnosis was mainly based on 'Meltzer's triad' of palpable purpura, arthral- gias and myalgias which is generally seen in essential, viral or connective tissue-associated cryoglobulinaemia. Moreover, a malignant tumour of the uterus was discov- ered a few months after the onset of renal disease; there- fore, a link between the two conditions could be hy- pothesized. Glomerulopathies with organized deposits are much less frequent than those with usual-type immune- complex deposits and are typically described in amy- loidosis, cryoglobulinaemic glomerulonephritis, fibrillary glomerulonephritis, immunotactoid glomerulopahty, col- lagenofibrotic glomerulopathy and fibronectin glomeru- lopathy (2). The generic term 'glomerular deposition dis- ease' has been proposed by pathologists (3). To the best of our knowledge this is the first time that comma-shaped electron-dense deposits in the mesangium, subepithelial and subendothelial spaces have been reported. Moreover, Ronco and Aucouturier (4) classified cryoglobulinaemia kidney as a microtubular organized deposit in their patho- logic classification of diseases with tissue depositions or precipitation of monoclonal Ig-related materials. We can- not exclude that the peculiar shape and diffuse distribution that we found could be related to the subsequent diagnosis of malignant uterine neoplasm.

Fibrillary comma-shaped electron-dense organized glomerular deposits associated with cryoglobulinaemia