UNIGE document Scientific Article - Case report
previous document  unige:20884  next document
add to browser collection
Title

Immunoglobulin deposition disease with a membranous pattern and a circulating monoclonal immunoglobulin G with charge-dependent aggregation properties

Authors
Bindi, Pascal
Debiec, Hanna
Alyanakian, Marie-Alexandra
Aymard, Bernadette
Callard, Patrice
Ronco, Pierre
Aucouturier, Pierre
Published in American Journal of Kidney Diseases. 2010, vol. 56, no. 1, p. 117-121
Abstract A 62-year-old woman presented with nephrotic syndrome, monoclonal gammopathy, and membranous-like nephropathy with nonorganized deposits composed of monoisotypic immunoglobulin G1 lambda protein. Nephrotic syndrome remitted after a brief course of treatment with melphalan despite ongoing production of the monoclonal protein. The circulating monoclonal immunoglobulin G1 lambda showed unusual in vitro aggregation properties, including dependence on low ionic strength and neutral pH, suggesting that electrostatic interactions had a role in the precipitation process. This case illustrates the importance of looking for monoclonal immunoglobulin deposits when kidney biopsy findings are suggestive of membranous nephropathy. In addition, our in vitro demonstrations of the role of physicochemical factors in immunoglobulin precipitation help elucidate the pathogenesis of immunoglobulin deposition disorders. Although binding to podocyte antigens is a well-recognized determinant of subepithelial immunoglobulin deposition, proneness to aggregation as described in this case also might be nephritogenic.
Keywords FemaleGlomerulonephritis, Membranous/*blood/*diagnosisHumansImmunoglobulin G/*bloodMiddle AgedMonoclonal Gammopathy of Undetermined Significance/*blood/*diagnosisParaproteinemias/blood/diagnosis
Identifiers
PMID: 20471736
Full text
Structures
Research groups Groupe Eric Féraille (néphrologie) (29)
Insuffisance rénale chronique (941)
Citation
(ISO format)
DE SEIGNEUX MATTHEY, Sophie et al. Immunoglobulin deposition disease with a membranous pattern and a circulating monoclonal immunoglobulin G with charge-dependent aggregation properties. In: American Journal of Kidney Diseases, 2010, vol. 56, n° 1, p. 117-121. https://archive-ouverte.unige.ch/unige:20884

189 hits

0 download

Update

Deposited on : 2012-05-23

Export document
Format :
Citation style :