Renal involvement in monoclonal (type I) cryoglobulinemia: Two cases associated with IgG3κ cryoglobulin

Renal involvement has been described rarely in monoclonal (type I) cryoglobulinemia, although this complication is frequent among patients with mixed (type II or III) cryoglobulin. We report two patients with glomerulonephritis and monoclonal IgGκ cryoglobulin. Both patients presented with nephrotic...

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Bibliographic Details
Published in:	American journal of kidney diseases Vol. 40; no. 5; pp. 1091 - 1096
Main Authors:	Karras, Alexandre, Noël, Laure-Hélène, Droz, Dominique, Delansorne, Dominique, Saint-André, Jean-Paul, Aucouturier, Pierre, Alyanakian, Marie-Alexandra, Grünfeld, Jean-Pierre, Lesavre, Philippe
Format:	Journal Article
Language:	English
Published:	Orlando, FL Elsevier Inc 01-11-2002 Elsevier
Subjects:	Aged Antibodies, Monoclonal - blood Biological and medical sciences Cryoglobulin cryoglobulinemia Cryoglobulinemia - classification Cryoglobulinemia - pathology Glomerulonephritis Glomerulonephritis, Membranoproliferative - blood Glomerulonephritis, Membranoproliferative - pathology Humans IgG3 Immunoglobulin G - blood Immunoglobulin kappa-Chains - blood Kidney - blood supply Kidney - immunology Kidney - pathology Male Medical sciences Middle Aged monoclonal immunoglobulin Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure IgG3 Cryoglobulin monoclonal immunoglobulin glomerulonephritis cryoglobulinemia Kidney disease Human Corticosteroid Urinary system disease Steroid hormone Methylprednisolone Monoclonal cryoglobulinemia Kidney Case study Pathology Alkylating agent Chemotherapy Cyclophosphamide Oxazaphosphinane derivatives Association Treatment Biopsy Nitrogen mustard Diagnosis Immunosuppressive agent Mesangial proliferative glomerulonephritis
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Summary:	Renal involvement has been described rarely in monoclonal (type I) cryoglobulinemia, although this complication is frequent among patients with mixed (type II or III) cryoglobulin. We report two patients with glomerulonephritis and monoclonal IgGκ cryoglobulin. Both patients presented with nephrotic syndrome, microscopic hematuria, and impaired renal function. Hepatitis C serology was negative, bone marrow aspiration was normal, and the renal biopsy specimen showed membranoproliferative glomerulonephritis with glomerular subendothelial deposits of monoclonal IgGκ. In both cases, circulating cryoglobulin and monotypic tissue deposits were found to be IgG3κ, suggesting that this isotype may have a particular propensity to cause this type of membranoproliferative glomerulonephritis. Although 18 cases of type I cryoglobulinemia with biopsy-proven glomerulonephritis have been reported to date, this is the first characterization of immunoglobulin heavy-chain isotype in this disease. Am J Kidney Dis 40:1091-1096. © 2002 by the National Kidney Foundation, Inc.
Bibliography:	ObjectType-Case Study-3 SourceType-Scholarly Journals-1 content type line 23 ObjectType-Review-1 ObjectType-Feature-5 ObjectType-Report-2 ObjectType-Article-4
ISSN:	0272-6386 1523-6838
DOI:	10.1053/ajkd.2002.36350