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.