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3 "Immunoglobulin A"
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A case of monoclonal gammopathy of renal significance presenting as atypical amyloidosis with IgA lambda paraproteinemia
Chankyung Kim, John Brealey, Anjelo Jobert, James Nolan
J Pathol Transl Med. 2020;54(6):504-507.   Published online November 9, 2020
DOI: https://doi.org/10.4132/jptm.2020.09.18
  • 3,274 View
  • 84 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Monoclonal gammopathy of renal significance is defined as any B cell or plasma cell clonal lymphoproliferation which neither causes tumor complications nor meets any current hematological criteria for specific therapy, with one or more kidney lesions related to the produced monoclonal immunoglobulin, such as amyloidosis. A 50-year-old male presented with heavy proteinuria and blood tests showing IgA and Lambda paraproteinemia. Light microscopy showed mesangial eosinophilic ground substance extending into the capillary loops, and positive staining within the glomeruli and vessel walls for amyloid P immunohistochemistry was also noted. Immunofluorescence showed positive staining for IgA and Lambda in the mesangia and capillary loops. Electron microscopy exhibited organized fibrils measuring 4–5 nm in diameter in the mesangia, glomerular basement membranes and vessel walls. We interpreted the overall findings as atypical renal amyloidosis with IgA and Lambda deposition on immunofluorescence. Further amyloid typing using laser microdissection-liquid chromatography and mass spectrometry will be useful.

Citations

Citations to this article as recorded by  
  • AB-Amy: machine learning aided amyloidogenic risk prediction of therapeutic antibody light chains
    Yuwei Zhou, Ziru Huang, Yushu Gou, Siqi Liu, Wei Yang, Hongyu Zhang, Anthony Mackitz Dzisoo, Jian Huang
    Antibody Therapeutics.2023; 6(3): 147.     CrossRef
Article image
Concurrent Anti-glomerular Basement Membrane Nephritis and IgA Nephropathy
Kwang-Sun Suh, Song-Yi Choi, Go Eun Bae, Dae Eun Choi, Min-kyung Yeo
J Pathol Transl Med. 2019;53(6):399-402.   Published online September 16, 2019
DOI: https://doi.org/10.4132/jptm.2019.08.05
  • 5,476 View
  • 178 Download
  • 10 Web of Science
  • 11 Crossref
AbstractAbstract PDFSupplementary Material
Anti–glomerular basement membrane (GBM) nephritis is characterized by circulating anti-GBM antibodies and crescentic glomerulonephritis (GN) with deposition of IgG along the GBM. In a limited number of cases, glomerular immune complexes have been identified in anti-GBM nephritis. A 38-year-old female presented azotemia, hematuria, and proteinuria without any pulmonary symptoms. A renal biopsy showed crescentic GN with linear IgG deposition along the GBM and mesangial IgA deposition. The patient was diagnosed as concurrent anti-GBM nephritis and IgA nephropathy. Therapies with pulse methylprednisolone and cyclophosphamide administration were effective. Concurrent cases of both anti-GBM nephritis and IgA nephropathy are rare among cases of anti-GBM diseases with deposition of immune complexes. This rare case of concurrent anti-GBM nephritis and IgA nephropathy with literature review is noteworthy.

Citations

Citations to this article as recorded by  
  • Coexistence of anti-glomerular basement membrane disease and IgA nephropathy: an illustrative case and comprehensive literature review
    Zewei Chen, Dechao Xu, Fangzheng Cui, Huihui Hou, Zhiguo Mao, Xiang Gao
    Renal Failure.2024;[Epub]     CrossRef
  • Clinical features and prognosis of patients with anti-GBM disease combined with mesangial IgA deposition
    Wei Ning, Ya-fei Zhao, Ya-ru Liu, Yuan-yuan Qi, Zhan-zheng Zhao
    Frontiers in Immunology.2024;[Epub]     CrossRef
  • Anti-glomerular basement membrane vasculitis
    Claudio Ponticelli, Marta Calatroni, Gabriella Moroni
    Autoimmunity Reviews.2023; 22(1): 103212.     CrossRef
  • High-frequency plasma exchange therapy for immunocompromised, type I crescentic glomerulonephritis complicated with IgA nephropathy: A case report and literature review
    Huihui Chen, Jingjing Jin, Mei Juan Cheng, Lei He, Wei Zhou, Liping Guo, Zhe Zhe Niu, Xiang Nan Liang, Rong Fang Zhu, Yaling Bai, Jin Sheng Xu
    Medicine.2023; 102(3): e32698.     CrossRef
  • Clinical and immunological characteristics of patients with combined anti-glomerular basement membrane disease and IgA nephropathy
    Cong-rong Shen, Xiao-yu Jia, Zhao Cui, Xiao-juan Yu, Ming-hui Zhao
    Clinical Kidney Journal.2023; 16(9): 1480.     CrossRef
  • Anti-glomerular basement membrane disease with IgA nephropathy: A case report
    Chuan Guo, Ming Ye, Shen Li, Ting-Ting Zhu, Xiang-Rong Rao
    World Journal of Clinical Cases.2022; 10(12): 3916.     CrossRef
  • Case Report: Coexistence of Anti-Glomerular Basement Membrane Disease, Membranous Nephropathy, and IgA Nephropathy in a Female PatientWith Preserved Renal Function
    Wei Qu, Nan Liu, Tianhua Xu, Binyao Tian, Meng Wang, Yanqiu Li, Jianfei Ma, Li Yao
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • Great prognosis of concurrent anti-GBM disease and IgA nephropathy in a young woman: A case report
    Fu Shaojie, Su Sensen, Huang Jingda, Wang Luyu, Zhang Fei, Yu Jinyu, Xu Zhonggao, Wu Hao
    Medicine.2022; 101(37): e30686.     CrossRef
  • Serodiagnosis of Anti-glomerular Basement Membrane Disease Using a Newly Developed Chemiluminescence Immunoassay
    Alexander Kühnl, Lea Hartwig, Cornelia Dähnrich, Wolfgang Schlumberger
    Frontiers in Medicine.2022;[Epub]     CrossRef
  • PATHOLOGY AND RENAL OUTCOME OF THREE UNCOMMON FACES OF CRESCENTRIC GLOMERULONEPHRITIS
    Keya Basu, Dipankar Sircar, Manimoy Bandopadhyay
    INDIAN JOURNAL OF APPLIED RESEARCH.2021; : 7.     CrossRef
  • Pneumocystis pneumonia secondary to intensive immunosuppression treatment for anti-GBM disease complicated with IgA nephropathy
    Manyu Zhang, Dingwei Yang, Weixiu Wang, Fuhao Zhao, Xiaoxiao Zhang, Xue Li
    Medicine.2021; 100(45): e27728.     CrossRef
Original Article
Clinicopathologic Features of IgA-Dominant Postinfectious Glomerulonephritis
Tai Yeon Koo, Gheun-Ho Kim, Moon Hyang Park
Korean J Pathol. 2012;46(2):105-114.   Published online April 25, 2012
DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.2.105
  • 10,636 View
  • 115 Download
  • 11 Crossref
AbstractAbstract PDF
Background

IgA-dominant acute postinfectious glomerulonephritis (APIGN) is a recently recognized morphologic variant of APIGN, but its clinicopathologic features were not clearly characterized. We will present demographic, clinical and renal biopsy findings from seven patients with IgA-dominant APIGN with a literature review.

Methods

All renal biopsy specimens (n=1,119) processed by the Department of Pathology in Hanyang University Hospital from 2005 to 2009 were reviewed. Seven patients with IgA-dominant APIGN were identified, and their clinical data analyzed.

Results

All patients had renal failure, hematuria and proteinuria. One was diabetic, and none of the patients had previous renal diseases. Three had clinical infections at the time of presentation: 2 with methicillin-resistant Staphylococcus aureus and one with rickettsial infection. Light microscopically diffuse endocapillary proliferative and exudative glomerulonephritis was found in all cases. Immunofluorescence microscopy showed granular IgA deposits along peripheral capillary walls and in mesangium. Ultrastructurally, subepithelial 'humps' with mesangial deposits were noted. End-stage renal disease developed in two patients, chronic renal failure was stationary in two, and azotemia improved in three.

Conclusions

Various infections including rickettsiosis preceded IgA-dominant APIGN in both diabetics and nondiabetics. Because the prognosis of IgA-dominant APIGN is poor, early diagnosis based on renal biopsy is required.

Citations

Citations to this article as recorded by  
  • Staphylococcus aureus Infection-Related Glomerulonephritis with Dominant IgA Deposition
    Mamiko Takayasu, Kouichi Hirayama, Homare Shimohata, Masaki Kobayashi, Akio Koyama
    International Journal of Molecular Sciences.2022; 23(13): 7482.     CrossRef
  • A rare case of Immunoglobulin A dominant post-infectious glomerulonephritis (IgA PIGN) in a young patient
    A. Saghar, G. Klaus, B. Trutnau, M. Kömhoff, H. J. Gröne, S. Weber
    BMC Nephrology.2022;[Epub]     CrossRef
  • IgA-Dominant Infection-Associated Glomerulonephritis Following SARS-CoV-2 Infection
    Aurora Pérez, Isidro Torregrosa, Luis D’Marco, Isabel Juan, Liria Terradez, Miguel Ángel Solís, Francesc Moncho, Carmen Carda-Batalla, María J. Forner, Jose Luis Gorriz
    Viruses.2021; 13(4): 587.     CrossRef
  • Relationship between blood neutrophil‐lymphocyte ratio and renal tubular atrophy/interstitial fibrosis in IgA nephropathy patients
    Lingxiong Chai, Kedan Cai, Kaiyue Wang, Qun Luo
    Journal of Clinical Laboratory Analysis.2021;[Epub]     CrossRef
  • The Continuing Need for Electron Microscopy in Examination of Medical Renal Biopsies: Examples in Practice
    Michifumi Yamashita, Mercury Y. Lin, Jean Hou, Kevin Y.M. Ren, Mark Haas
    Glomerular Diseases.2021; 1(3): 145.     CrossRef
  • Clinicopathologic features of infection-related glomerulonephritis with IgA deposits: a French Nationwide study
    Elodie Miquelestorena-Standley, Charlotte Jaulerry, Marie-Christine Machet, Nolwenn Rabot, Christelle Barbet, Aurélie Hummel, Alexandre Karras, Cyril Garrouste, Thomas Crepin, Didier Ducloux, Maud Cousin, Catherine Albert, Joseph Rivalan, Emilie Cornec-Le
    Diagnostic Pathology.2020;[Epub]     CrossRef
  • IgA nephropathy and infections
    Cristiana Rollino, Gisella Vischini, Rosanna Coppo
    Journal of Nephrology.2016; 29(4): 463.     CrossRef
  • <i>Staphylococcus</i>-associated Glomerulonephritis
    Dong Yeol Shin, Sung Han Kim, Ji Wan Lee, Ki Ju Chang, Seung Ha Hwang, Yong Mee Cho, Soon Bae Kim
    The Korean Journal of Medicine.2016; 90(2): 148.     CrossRef
  • Use of steroid therapy in immunoglobulin A-dominant poststaphylococcal glomerulonephritis
    Mahesh Eswarappa, Vijay Varma, K.C. Gurudev
    Hong Kong Journal of Nephrology.2015; 17(2): 46.     CrossRef
  • Clinicopathologic Features of IgA-Dominant Infection-Associated Glomerulonephritis: A Pooled Analysis of 78 Cases
    Ru Bu, Qian Li, Zhi-yu Duan, Jie Wu, Pu Chen, Xiang-mei Chen, Guang-yan Cai
    American Journal of Nephrology.2015; 41(2): 98.     CrossRef
  • Garland-pattern postinfectious glomerulonephritis with IgA-dominant deposition
    Makoto Kanno, Kenichi Tanaka, Hiroshi Kimura, Kimio Watanabe, Yoshimitsu Hayashi, Koichi Asahi, Masaaki Nakayama, Kensuke Joh, Tsuyoshi Watanabe
    CEN Case Reports.2014; 3(1): 56.     CrossRef

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