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] |
---|
Links: |
Volltext [lizenzpflichtig] |
---|
Themen: |
Clinical nephrology |
---|
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): |
SPR049214306 |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | SPR049214306 | ||
003 | DE-627 | ||
005 | 20230519105205.0 | ||
007 | cr uuu---uuuuu | ||
008 | 230202s2022 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1007/s13730-022-00714-1 |2 doi | |
035 | |a (DE-627)SPR049214306 | ||
035 | |a (SPR)s13730-022-00714-1-e | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Sugita, Erina |e verfasserin |4 aut | |
245 | 1 | 0 | |a Diagnosis of monoclonal immunotactoid glomerulopathy with positive λ chain by immunoelectron microscopy |
264 | 1 | |c 2022 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a Computermedien |b c |2 rdamedia | ||
338 | |a Online-Ressource |b cr |2 rdacarrier | ||
500 | |a © The Author(s) under exclusive licence to The Japan Society of Nephrology 2022 | ||
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 |7 (dpeaa)DE-He213 | |
650 | 4 | |a Clinical nephrology |7 (dpeaa)DE-He213 | |
650 | 4 | |a Nephrotic syndrome |7 (dpeaa)DE-He213 | |
700 | 1 | |a Sonoda, Homare |4 aut | |
700 | 1 | |a Ryuzaki, Masaki |4 aut | |
700 | 1 | |a Hashiguchi, Akinori |4 aut | |
700 | 1 | |a Tokuyama, Hirobumi |4 aut | |
700 | 1 | |a Wakino, Shu |4 aut | |
700 | 1 | |a Kanda, Takeshi |4 aut | |
700 | 1 | |a Itoh, Hiroshi |4 aut | |
773 | 0 | 8 | |i Enthalten in |t CEN Case Reports |d Tokyo : Springer Japan, 2012 |g 12(2022), 1 vom: 14. Juni, Seite 7-13 |w (DE-627)SPR032206895 |w (DE-600)2660492-9 |x 2192-4449 |7 nnns |
773 | 1 | 8 | |g volume:12 |g year:2022 |g number:1 |g day:14 |g month:06 |g pages:7-13 |
856 | 4 | 0 | |u https://dx.doi.org/10.1007/s13730-022-00714-1 |z lizenzpflichtig |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_SPRINGER | ||
912 | |a SSG-OLC-PHA | ||
951 | |a AR | ||
952 | |d 12 |j 2022 |e 1 |b 14 |c 06 |h 7-13 |