Open AccessMicrolamellar Structures in Lobular Glomerulonephritis Associated with Monoclonal IgG Lambda Paraproteinemia
Author(s) -
Joh Kensuke,
Aizawa Higeo,
Takahashi Takamune,
Hatakeyama Makio,
Muto Shigeaki,
Asano Yasushi,
Shimizu Hideo,
Suzuki Ryoji
Publication year - 1990
Publication title -
acta patholigica japonica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
ISSN - 0001-6632
DOI - 10.1111/j.1440-1827.1990.tb03338.x
Subject(s) - paraproteinemia , cryoglobulin , cryoglobulinemia , microhematuria , pathology , medicine , glomerulonephritis , immunoglobulin light chain , monoclonal , amyloidosis , bence jones protein , paraproteinemias , cryoglobulins , nephrotic syndrome , macroglobulinemia , antibody , immunology , multiple myeloma , proteinuria , monoclonal antibody , gastroenterology , kidney , hepatitis c virus , virus
We report a 49 year old woman who developed lobular glomerulonephritis with prevalent deposition of material positive for IgG, C 1q and lambda light chain, but which was not stained by Congo red. Glomeruli revealed massive electron‐dense deposits with a microlamellar structure in the mesangial matrix and peripheral capillary loops. Clinically, the patient had nephrotic syndrome, microhematuria and hypertension. No Bence Jones protein or cryoglobulin was found in the urine or serum. Anti‐DNA antibody was positive, but systemic lupus erythematosus (SLE) was ruled out by repeated serological examinations. Immunoelectrophoresis of blood and urine revealed increased IgG lambda paraprotein, but no free light chains were found. We reviewed 54 cases reported in the literature, which showed organized crystalline structures on ultrastructural examination, but were unassociated with amyloidosis, SLE, cryoglobulinemia or multiple myeloma. The present patient is the first reported to have exhibited a combination of glomerulonephritis with organized deposits, monoclonal IgG lambda paraproteinemia, and the presence of anti DNA antibody. Acta Pathol Jpn 40: 913 921, 1990.