ArticleBMC nephrology2018
An IgA1-lambda-type monoclonal immunoglobulin deposition disease associated with membranous features in a patient with IgG4-related kidney disease: a case report.
Article in BMC nephrology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 11 citations in OpenAlex.
- Antineutrophil Cytoplasmic Antibody-Associated Vasculitis Overlapping with IgG4-Related Disease Accompanied by Mesangial Immunoglobulin a Deposition: A Case Report.Journal of inflammation research · 2026Article
- Concurrent IgG4-related membranous nephropathy and proliferative diabetic kidney disease: a diagnostic dilemma and therapeutic strategy in long-standing diabetes.BMC nephrology · 2025Article
- Mechanism of hyperproteinemia-induced damage to female reproduction in a genetic silkworm model.iScience · 2023Article
- Idiopathic Membranous Nephropathy with Solitary Immunoglobulin A Deposition: A Case Report and a Review of the Literature.Internal medicine (Tokyo, Japan) · 2022Review
- Mechanism of hyperproteinemia-induced blood cell homeostasis imbalance in an animal model.Zoological research · 2022Article
- Influence of Hyperproteinemia on Insect Innate Immune Function of the Circulatory System inBiology · 2021Article
- Membranous Nephropathy With Monoclonal IgM Lambda Deposits in a Patient With IgM Monoclonal Gammopathy: A Case Report.Frontiers in medicine · 2021Article
- KM55 Monoclonal Antibody and IgA Variant of Proliferative Glomerulonephritis With Monoclonal Ig Deposits.Kidney international reports · 2020Article
- Membranous nephropathy with solitary polyclonal IgA deposition: A case report and literature review.Clinical nephrology. Case studies · 2019Article
- Eosinophilia and Kidney Disease: More than Just an Incidental Finding?Journal of clinical medicine · 2018Review
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIgG4-related disease (IgG4-RD) is a newly recognized fibroinflammatory condition. The kidney is one of the organs commonly affected by IgG4-RD. Tubulointerstitial nephritis (TIN) is the main feature, and membranous nephropathy (MN) has also been described frequently. In MN, polyclonal immunoglobulins and complements are deposited in granular form along the glomerular basement membranes (GBMs). Unusual cases of monoclonal immunoglobulin deposition disease (MIDD) associated with membranous features have been reported. MIDD is morphologically similar to MN but contains immunoglobulins considered to be derived from single B-cell clone. CASE PRESENTATION: We describe a 65-year-old man who was referred to our hospital because of hyperproteinaemia, eosinophilia, anaemia, and proteinuria. A renal biopsy demonstrated infiltration of plasma cells and eosinophils in the interstitium, and the ratio of IgG4-positive plasma cells to IgG-positive plasma cells was 55%. The patient was diagnosed as having IgG4-related TIN. Periodic acid methenamine silver staining under light microscopy revealed a bubbling appearance and spike formation in the GBM. On immunofluorescence, the expression of IgG and complements was negative; however, IgA was positively expressed in a granular pattern along the GBM. An IgA subclass analysis revealed a significant deposition of IgA1-lambda (IgA1-λ). Electron microscopy revealed irregular and small non-organized and non-Randall-type granular electron-dense deposits in the GBM that were shaped like snow leopard spots.
conclusionsAfter corticosteroid therapy was initiated, the patient's eosinophilia remarkably improved and his serum creatinine, IgG, and IgG4 levels decreased to within the normal ranges. However, massive proteinuria persisted. To our knowledge, this is the first reported case of IgG4-related TIN associated with IgA1-λ-type MIDD with membranous features.
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