Membranous nephropathy with monoclonal IgG4 deposits and associated IgG4-related lung disease.
Membranous nephropathy with monoclonal IgG4 deposits and associated IgG4-related lung disease.
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DOI：
10.1093/ckj/sfu077
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发表时间：
2014-10
影响因子：
4.6
通讯作者：
Wakui H
中科院分区：
文献类型：
--
作者：
Omokawa A;Komatsuda A;Hirokawa M;Wakui H
一位62岁女性因肾病综合征和肺部肿瘤入院。肾活检显示肾小球的膜性特征。免疫荧光研究显示颗粒状IgG 4-κ沉积沿着肾小球基底膜。电子显微镜显示颗粒状电子致密沉积物。进一步研究否认多发性骨髓瘤。切除的肺肿瘤的光学显微镜检查显示IgG 4相关的肺部疾病，没有恶性肿瘤。类固醇治疗诱发肾病综合征缓解，肺肿瘤无复发。我们认为，这是第一例增生性肾小球肾炎与单克隆IgG沉积的IgG 4亚类，并罕见的并发症与IgG 4相关的疾病。
A 62-year-old woman was admitted for nephrotic syndrome and lung tumor. A renal biopsy showed membranous features of the glomeruli. Immunofluorescence studies revealed granular IgG4-κ deposits along with the glomerular basement membrane. Electron microscopy revealed granular electron-dense deposits. Further study denied multiple myeloma. Light microscopy of the resected lung tumor revealed IgG4-related lung disease with no malignancy. Steroid therapy induced a remission of the nephrotic syndrome, with no recurrence of the lung tumor. We consider that this is the first case of a proliferative glomerulonephritis with monoclonal IgG deposits of IgG4 subclass, and a rare concurrence with IgG4-related disease.