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2013 ; 2
(2
): 222-227
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Proliferative glomerulonephritis with monoclonal IgM-? deposits in chronic
lymphocytic leukemia/small lymphocytic leukemia: case report and review of the
literature
#MMPMID28509294
Oe Y
; Joh K
; Sato M
; Taguma Y
; Onishi Y
; Nakayama K
; Sato T
CEN Case Rep
2013[Nov]; 2
(2
): 222-227
PMID28509294
show ga
A 48-year-old man with chronic lymphocytic leukemia presented with nephrotic
syndrome, hematuria, and mild deterioration of renal function. Further analysis
using serum immunofixation electrophoresis detected monoclonal immunoglobulin
(Ig) M-? and IgG-? M-protein. Testing for cryoglobulin in serum was negative.
Light microscopy of a renal biopsy specimen showed membranoproliferative
glomerulonephritis features with marked mononuclear cell infiltration in the
interstitium. On immunofluorescence study, the deposition of IgM heavy chain was
predominantly observed with the same distribution of ? light chain, whereas no ?
light chain was found. Electron microscopy revealed fine granular deposits in the
mesangial, subendothelial, and subepithelial areas, mimicking those observed in
the immune complex-mediated glomerulonephritis. These pathological findings were
consistent with recently described cases of proliferative glomerulonephritis with
monoclonal IgG deposits. Thus, monoclonal IgM deposition can also cause
proliferative glomerulonephritis.