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首页> 外文期刊>CEN Case Reports >Proliferative glomerulonephritis with monoclonal IgM-κ deposits in chronic lymphocytic leukemia/small lymphocytic leukemia: case report and review of the literature
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Proliferative glomerulonephritis with monoclonal IgM-κ deposits in chronic lymphocytic leukemia/small lymphocytic leukemia: case report and review of the literature

机译：慢性淋巴细胞白血病/小淋巴细胞白血病中具有单克隆IgM-κ沉积物的增生性肾小球肾炎：病例报告和文献复习

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摘要

A 48-year-old man with chronic lymphocytic leukemia presented with nephrotic syndrome, hematuria, and mild deterioration of renal function. Further analysis using serum immunofixation electrophoresis detected monoclonal immunoglobulin (Ig) M-κ and IgG-κ M-protein. Testing for cryoglobulin in serum was negative. Light microscopy of a renal biopsy specimen showed membranoproliferative glomerulonephritis features with marked mononuclear cell infiltration in the interstitium. On immunofluorescence study, the deposition of IgM heavy chain was predominantly observed with the same distribution of κ light chain, whereas no λ light chain was found. Electron microscopy revealed fine granular deposits in the mesangial, subendothelial, and subepithelial areas, mimicking those observed in the immune complex-mediated glomerulonephritis. These pathological findings were consistent with recently described cases of proliferative glomerulonephritis with monoclonal IgG deposits. Thus, monoclonal IgM deposition can also cause proliferative glomerulonephritis.
机译：一名48岁的慢性淋巴细胞性白血病患者表现为肾病综合征，血尿和肾功能轻度恶化。使用血清免疫固定电泳的进一步分析检测到了单克隆免疫球蛋白（Ig）M-κ和IgG-κM蛋白。血清中冷球蛋白测试为阴性。肾活检标本的光学显微镜显示，膜增生性肾小球肾炎的特征是间质中有明显的单核细胞浸润。在免疫荧光研究中，主要观察到IgM重链的沉积，κ轻链分布相同，而未发现λ轻链。电镜观察发现，在肾小球膜，内皮下和上皮下区域有细小颗粒状沉积物，与免疫复合物介导的肾小球肾炎中观察到的相似。这些病理发现与最近描述的具有单克隆IgG沉积物的增生性肾小球肾炎病例一致。因此，单克隆IgM沉积也会引起增殖性肾小球肾炎。

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