Kidney Res Clin Pract.  2015 Jun;34(2):117-119. 10.1016/j.krcp.2014.10.008.

Fibrillary glomerulonephritis combined with chronic inflammatory demyelinating polyneuropathy

• Sung WK
• Jeong JU
• Bang KT
• Shin JH
• Yoo JH
• Kim NM
• Park JH
• Kim JH

• KMID: 2381528
• DOI: http://doi.org/10.1016/j.krcp.2014.10.008

Abstract

A 58-yr-old man presented with leg edema and subacute weakness of his bilateral lower extremities. Urinary and serum immunoelectrophoresis revealed the presence of lambda-type Bence Jones proteins. He was ultimately diagnosed with monoclonal gammopathy of undetermined significance (MGUS). A renal biopsy specimen showed fibrillary glomerulonephritis (FGN), which was randomly arranged as 12-20 m nonbranching fibrils in the basement membranes. Immunofluorescence studies were negative for immunoglobulin (Ig)G, IgM, IgA, C3, and kappa light chains in the capillary walls and mesangial areas. A Congo red stain for amyloid was negative. Electromyography and nerve conduction velocity examinations results were compatible with the presence of demyelinating polyneuropathy. This case showed a rare combination of FGN, without Ig deposition, and MGUS combined with chronic inflammatory demyelinating polyneuropathy (CIDP).

Keyword

Fibrillary glomerulonephritis; Monoclonal gammopathy; Polyneuropathy

MeSH Terms

Amyloid
Basement Membrane
Bence Jones Protein
Biopsy
Capillaries
Congo Red
Edema
Electromyography
Fluorescent Antibody Technique
Glomerulonephritis*
Immunoelectrophoresis
Immunoglobulin A
Immunoglobulin M
Immunoglobulins
Leg
Lower Extremity
Monoclonal Gammopathy of Undetermined Significance
Neural Conduction
Paraproteinemias
Polyneuropathies*
Amyloid
Bence Jones Protein
Congo Red
Immunoglobulin A
Immunoglobulin M
Immunoglobulins