增生性肾小球肾炎伴晶格状结构的单克隆IgG沉积

肾脏病与透析肾移植杂志 ›› 2011, Vol. 20 ›› Issue (4): 384-390.

增生性肾小球肾炎伴晶格状结构的单克隆IgG沉积

出版日期:2011-08-31 发布日期:2011-09-01

Proliferative glomerulonephritis with monoclonal IgG deposits associated with crystal lattice features

Online:2011-08-31 Published:2011-09-01

摘要/Abstract

摘要：

51岁男性，病程1月。以高血压起病，肾脏损害主要表现大量蛋白尿，低白蛋白血症，伴少量镜下血尿，肾功能异常。肾外表现有轻度贫血，为正细胞正色素性，血清免疫固定电泳提示κ型IgG单克隆免疫球蛋白条带，骨髓活检和骨髓细胞学检查均阴性。肾活检组织光镜下为系膜细胞、内皮细胞增生，袢内较多CD68阳性细胞浸润，大量内皮下、少量系膜区、偶见上皮侧嗜复红物沉积，沉积物只有IgG1和γ轻链阳性，超微结构观察到的沉积物具有晶格状结构。免疫电镜证实这些晶格状的物质IgG和γ轻链阳性。最终诊断为伴晶格状结构的增生性肾小球肾炎伴单克隆IgG沉积。

关键词: 单克隆免疫球蛋白IgG沉积性肾小球病, 单克隆&gamma, 病, 晶格状结构

Abstract:

A 51-year old man was reffered in January 2011 because of hypertension, proteinuria, hypoalbuminemia, mild microscopic hematuria and mild renal dysfunction. He had anemia and serum IgG kappa monoclonal component. Bone marrow biopsy and bone marrow cytomorphologic examination indicated normal finding. Analysis of the kidney biopsy showed mesangial and endothelial cell proliferation with intracapillary CD68 positive cell infiltration. There were massive subendothelial, mild mesangial area and occational subepithelial deposits which were only positive staining for IgG1 and kappa light chain. Electron microscopy showed the deposits had crystal lattice appearance. The final diagnosis was proliferative glomerulonephritis with monoclonal IgG deposits associated with crystal lattice features.

曾彩虹, 朱小东. 增生性肾小球肾炎伴晶格状结构的单克隆IgG沉积[J]. 肾脏病与透析肾移植杂志, 2011, 20(4): 384-390.

ZENG Cai-hong, ZHU Xiao-dong. Proliferative glomerulonephritis with monoclonal IgG deposits associated with crystal lattice features[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, 2011, 20(4): 384-390.

ISSN 1006-298X CN 32-1425/R