Myeloperoxidase anti-cytoplasmic antibody related crescentic glomerulonephritis in a patient with IgG3λ monoclonal immunoglobulin deposition disease with membranous features.

Ayano Ito, Naoto Miura, Yukihiro Kimura, Sayaka Maeda, Keisuke Suzuki, Wataru Kitagawa, Hiroyuki Morita, Shogo Banno, Hirokazu Imai

Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Japan.

Internal medicine (Tokyo, Japan) 2012

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A 68-year-old woman showed rapidly progressive glomerulonephritis based on the fact that she had 1+ proteinuria (1.1 g/day), a 3+ occult blood reaction, blood urea nitrogen of 32.4 mg/dL, serum creatinine of 2.96 mg/dL, and myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibodies (ANCA) at 52 ELISA Unit (normal range: below 10). A renal biopsy demonstrated a bubbling appearance associated with cellular crescent formation with segmental necrosis. Immunofluorescence studies showed granular IgG3λ deposition along the basement membrane and in the mesangial area. This is the first English-language case report describing MPO-ANCA positive crescentic glomerulonephritis in a patient demonstrating monoclonal immunoglobulin deposition disease with mainly membranous features.

Citation

Ayano Ito, Naoto Miura, Yukihiro Kimura, Sayaka Maeda, Keisuke Suzuki, Wataru Kitagawa, Hiroyuki Morita, Shogo Banno, Hirokazu Imai. Myeloperoxidase anti-cytoplasmic antibody related crescentic glomerulonephritis in a patient with IgG3λ monoclonal immunoglobulin deposition disease with membranous features. Internal medicine (Tokyo, Japan). 2012;51(17):2393-7