Proliferative Glomerulonephritis With Monoclonal IgG Deposits Recurs or May Develop De Novo in Kidney Allografts
Proliferative Glomerulonephritis With Monoclonal IgG Deposits Recurs or May Develop De Novo in Kidney Allografts
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DOI：
10.1053/j.ajkd.2011.05.003
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发表时间：
2011-08-01
影响因子：
13.2
通讯作者：
Nadasdy, Tibor
中科院分区：
文献类型：
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作者：
Albawardi, Alia;Satoskar, Anjali;Nadasdy, Tibor
单克隆免疫球蛋白G（IgG）沉积性肾小球肾炎（PGNMIGD）是最近认识到的肾小球疾病。光学显微镜检查通常类似于膜增生性肾小球肾炎。肾小球沉积物主要是IgG 3 κ;然而，与通常形式的单克隆免疫球蛋白沉积病不同，不存在肾小球外沉积物。如果PGNMIGD继发于循环单克隆IgG的肾小球沉积，则预期其在同种异体肾移植物中以相同的单克隆IgG沉积模式复发。我们回顾了2003年1月1日至2010年1月4日期间的肾活检文件，发现21例PGNMIGD活检标本，大多数为肾小球IgG 3 κ沉积。在21例活检标本中，4例来自同种异体肾移植; 2例为复发性疾病，另外2例为新发疾病。复发性PGNMIGD发展迅速，引起蛋白尿。PGNMIGD在同种异体肾移植物中的快速复发进一步证明PGNMIGD继发于循环单克隆IgG的肾小球沉积。美国肾脏病杂志58（2）：276-281。(C)2011年，美国国家肾脏基金会（National Kidney Foundation，Inc.）
Proliferative glomerulonephritis with monoclonal immunoglobulin G (IgG) deposits (PGNMIGD) is a recently recognized glomerular disease. Light microscopy usually resembles membranoproliferative glomerulonephritis. Glomerular deposits are mostly IgG3 kappa; however, unlike in the usual forms of monoclonal immunoglobulin deposition disease, extraglomerular deposits are absent. If PGNMIGD is secondary to the glomerular deposition of circulating monoclonal IgG, it is expected to recur in kidney allografts with the same pattern of monoclonal IgG deposition. We reviewed our kidney biopsy files between January 1, 2003, and January 4, 2010, and identified 21 biopsy specimens with PGNMIGD, mostly with glomerular IgG3 kappa deposits. Of the 21 biopsy specimens, 4 were from kidney allografts; 2 were recurrent and the other 2 were de novo diseases. Recurrent PGNMIGD develops rapidly, causing proteinuria. This rapid recurrence of PGNMIGD in kidney allografts provides further proof that PGNMIGD is secondary to the glomerular deposition of circulating monoclonal IgG. Am J Kidney Dis. 58(2): 276-281. (C) 2011 by the National Kidney Foundation, Inc.