Abstract:

A 65yearold man who had recurrent skin purpura rash developed nephrotic symdrome, hematuria, renal failure, hypertension, as well as extrarenal manifestations of anemia, decreased C3, and elevated κ∶λ ratio. Renal biopsy showed membranoproliferative glomerulonephritis (MPGN). Immunoflurerscence indicated granular staining of capillary loop and mesangium in glomeruli for IgA, κ and λ light chain. Ultrastructral examination showed presence of electrondense deposition of microtubules that had distinct hollow centers with 3347 nm in diameter, arranged in parallel in the mesangium, subendothelial and rarely in the subepithelial area. The final diagnosis was immunotactoid glomerulopathy with prevalent IgA deposition.