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First case report of monoclonal IgG3-heavy-chain glomerulonephritis with microtubular structures

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Abstract

Our patient was a 69-year-old woman admitted to our hospital for heavy proteinuria and hematuria. A renal biopsy showed findings similar to those of membranoproliferative glomerulonephritis associated with nodular lesions, and immunofluorescence showed marked deposits of IgG, C1q, and C3 on the peripheral capillary walls. IgG3 alone was observed on IgG subclass staining with no κ or λ light chains, and Congo red staining was negative. These findings suggested IgG3-heavy-chain deposition disease (HCDD). However, we did not find a deletion of the first heavy-chain constant domain, which is commonly observed in HCDD. Electron microscopy showed randomly arranged subendothelial microtubular structures with diameters of 70–90 nm. Altogether, the diagnosis of HCDD could not be made, although monoclonal IgG3 deposits in glomeruli were observed. This is the first case report of monoclonal IgG3-heavy-chain glomerulonephritis with subendothelial-based, randomly arranged microtubular structures with diameters of 70–90 nm.

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Authors and Affiliations

  1. Department of Nephrology and Rheumatology, Iwate Prefectural Central Hospital, 1-4-1, Ueda, Morioka, Japan

    Yuki Matsuura, Taijiro Goto, Yoshihiko Tamayama, Yuki Nakamura, Junji Oyama, Hirotaka Ishioka, Kazuhiro Yoshikawa, Izaya Nakaya & Jun Soma

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  1. Yuki Matsuura
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  2. Taijiro Goto
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  3. Yoshihiko Tamayama
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  4. Yuki Nakamura
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  5. Junji Oyama
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  6. Hirotaka Ishioka
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  7. Kazuhiro Yoshikawa
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  8. Izaya Nakaya
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  9. Jun Soma
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Correspondence to Yuki Matsuura.

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Matsuura, Y., Goto, T., Tamayama, Y. et al. First case report of monoclonal IgG3-heavy-chain glomerulonephritis with microtubular structures. CEN Case Rep 10, 236–240 (2021). https://doi.org/10.1007/s13730-020-00550-1

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  • DOI: https://doi.org/10.1007/s13730-020-00550-1

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