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Renal involvement in monoclonal (type I) cryoglobulinemia: two cases associated with IgG3 kappa cryoglobulin.

Abstract
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 IgGkappa 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 IgGkappa. In both cases, circulating cryoglobulin and monotypic tissue deposits were found to be IgG3kappa, 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.
AuthorsAlexandre Karras, Laure-Hélène Noël, Dominique Droz, Dominique Delansorne, Jean-Paul Saint-André, Pierre Aucouturier, Marie-Alexandra Alyanakian, Jean-Pierre Grünfeld, Philippe Lesavre
JournalAmerican journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 40 Issue 5 Pg. 1091-6 (Nov 2002) ISSN: 1523-6838 [Electronic] United States
PMID12407656 (Publication Type: Case Reports, Journal Article, Review)
CopyrightCopyright 2002 by the National Kidney Foundation, Inc.
Chemical References
  • Antibodies, Monoclonal
  • Immunoglobulin G
  • Immunoglobulin kappa-Chains
Topics
  • Aged
  • Antibodies, Monoclonal (blood)
  • Cryoglobulinemia (classification, pathology)
  • Glomerulonephritis, Membranoproliferative (blood, pathology)
  • Humans
  • Immunoglobulin G (blood)
  • Immunoglobulin kappa-Chains (blood)
  • Kidney (blood supply, immunology, pathology)
  • Male
  • Middle Aged

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