Details der Publikation - Diagnosis of monoclonal immunotactoid glomerulopathy with positive λ chain by immunoelectron microscopy

Diagnosis of monoclonal immunotactoid glomerulopathy with positive λ chain by immunoelectron microscopy

Abstract We report the case of a 73-year-old-man who developed immunotactoid glomerulopathy (ITG). ITG is a rare disease characterized by proliferative glomerulonephritis and capillary wall deposits with a 10–60 nm diameter microtubular substructure. In monoclonal ITG, immunofluorescence analysis typically exhibits IgG with light chain restriction. Recent reviews recommend distinguishing monoclonal ITG from polyclonal ITG because monoclonal ITG is associated with a higher incidence of hematological disorders and better responsiveness to clone-directed therapy and renal prognosis. In our case, IgG, IgA, and IgM were negative by routine immunofluorescence; however, immunoelectron microscopy revealed positive λ chain. At 6 months after renal biopsy, the IgG λ chain was detected in the serum and urine, reflecting possible monoclonality. Therefore, it is useful to perform immunoelectron microscopy and follow-up with serum and urine protein electrophoresis and immunofixation to diagnose monoclonal ITG, even when routine immunofluorescence shows negative or nonspecific findings..

Medienart:	E-Artikel

Erscheinungsjahr:	2022
Erschienen:	2022

Enthalten in:	Zur Gesamtaufnahme - volume:12
Enthalten in:	CEN Case Reports - 12(2022), 1 vom: 14. Juni, Seite 7-13

Sprache:	Englisch

Beteiligte Personen:	Sugita, Erina [VerfasserIn] Sonoda, Homare [VerfasserIn] Ryuzaki, Masaki [VerfasserIn] Hashiguchi, Akinori [VerfasserIn] Tokuyama, Hirobumi [VerfasserIn] Wakino, Shu [VerfasserIn] Kanda, Takeshi [VerfasserIn] Itoh, Hiroshi [VerfasserIn]

Links:	Volltext [lizenzpflichtig]

Themen:	Clinical nephrology Immunotactoid glomerulopathy Nephrotic syndrome

Anmerkungen:	© The Author(s) under exclusive licence to The Japan Society of Nephrology 2022

doi:	10.1007/s13730-022-00714-1

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	OLC2133713093

Internformat


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520			\|a Abstract We report the case of a 73-year-old-man who developed immunotactoid glomerulopathy (ITG). ITG is a rare disease characterized by proliferative glomerulonephritis and capillary wall deposits with a 10–60 nm diameter microtubular substructure. In monoclonal ITG, immunofluorescence analysis typically exhibits IgG with light chain restriction. Recent reviews recommend distinguishing monoclonal ITG from polyclonal ITG because monoclonal ITG is associated with a higher incidence of hematological disorders and better responsiveness to clone-directed therapy and renal prognosis. In our case, IgG, IgA, and IgM were negative by routine immunofluorescence; however, immunoelectron microscopy revealed positive λ chain. At 6 months after renal biopsy, the IgG λ chain was detected in the serum and urine, reflecting possible monoclonality. Therefore, it is useful to perform immunoelectron microscopy and follow-up with serum and urine protein electrophoresis and immunofixation to diagnose monoclonal ITG, even when routine immunofluorescence shows negative or nonspecific findings.
650		4	\|a Immunotactoid glomerulopathy
650		4	\|a Clinical nephrology
650		4	\|a Nephrotic syndrome
700	1		\|a Sonoda, Homare \|4 aut
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700	1		\|a Wakino, Shu \|4 aut
700	1		\|a Kanda, Takeshi \|4 aut
700	1		\|a Itoh, Hiroshi \|4 aut
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912			\|a GBV_ILN_150
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912			\|a GBV_ILN_170
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912			\|a GBV_ILN_187
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912			\|a GBV_ILN_213
912			\|a GBV_ILN_224
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912			\|a GBV_ILN_281
912			\|a GBV_ILN_285
912			\|a GBV_ILN_293
912			\|a GBV_ILN_370
912			\|a GBV_ILN_602
912			\|a GBV_ILN_636
912			\|a GBV_ILN_702
912			\|a GBV_ILN_2001
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912			\|a GBV_ILN_2065
912			\|a GBV_ILN_2068
912			\|a GBV_ILN_2088
912			\|a GBV_ILN_2093
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912			\|a GBV_ILN_2111
912			\|a GBV_ILN_2112
912			\|a GBV_ILN_2113
912			\|a GBV_ILN_2118
912			\|a GBV_ILN_2122
912			\|a GBV_ILN_2129
912			\|a GBV_ILN_2134
912			\|a GBV_ILN_2143
912			\|a GBV_ILN_2144
912			\|a GBV_ILN_2147
912			\|a GBV_ILN_2148
912			\|a GBV_ILN_2152
912			\|a GBV_ILN_2153
912			\|a GBV_ILN_2188
912			\|a GBV_ILN_2232
912			\|a GBV_ILN_2336
912			\|a GBV_ILN_2446
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912			\|a GBV_ILN_2472
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912			\|a GBV_ILN_4112
912			\|a GBV_ILN_4125
912			\|a GBV_ILN_4126
912			\|a GBV_ILN_4242
912			\|a GBV_ILN_4246
912			\|a GBV_ILN_4249
912			\|a GBV_ILN_4251
912			\|a GBV_ILN_4305
912			\|a GBV_ILN_4306
912			\|a GBV_ILN_4307
912			\|a GBV_ILN_4313
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Diagnosis of monoclonal immunotactoid glomerulopathy with positive λ chain by immunoelectron microscopy

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