Title
Proliferative glomerulonephritis with monoclonal IgG deposits: a unique case with a clinical course of over 46 years
Authors
Tyler James1 , Marjan Afrouzian2 , Luan Truong3 , Omar Aleter4 , John Badalamenti5 and Hania Kassem5
Journal
BMC Nephrology
Abstract
Background: Proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) is a rare entity first described in 2004. We present a case of PGNMID with recurrent hematuria and nephrotic range proteinuria with three biopsies over
46 years.
Case presentation: A 79-year-old Caucasian female presents with a history of two separate episodes of biopsy-proven recurrent GN over a course of 46 years. Both biopsies from 1974, and 1987 were reported as membranoproliferative GN (MPGN).
The patient presented in 2016 for the third time with symptoms of fluid overload, slight worsening in renal function, and proteinuria along with glomerular hematuria. A third kidney biopsy was performed, and the final diagnosis was proliferative glomerulonephritis
with monoclonal IgG/κ deposits.
Conclusion: With three renal biopsies obtained over 46 years, our case opens a unique window into the natural history of PGNMID. The three biopsies demonstrate the immunologic and morphologic evolution of PGNMID in the kidney.