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Renal involvement in monoclonal (type I) cryoglobulinemia: Two cases associated with IgG3κ cryoglobulin

2002; Elsevier BV; Volume: 40; Issue: 5 Linguagem: Inglês

10.1053/ajkd.2002.36350

1523-6838

Alexandre Karras, Laure‐Hélène Noël, D Droz, Dominique Delansorne, Jean‐Paul Saint‐André, Pièrre Aucouturier, Marie‐Alexandra Alyanakian, Jean‐Pierre Grünfeld, Philippe Lesavre,

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Renal involvement has been described rarely in monoclonal (type I) cryoglobulinemia, although this complication is frequent among patients with mixed (type II or III) cryoglobulin. We report two patients with glomerulonephritis and monoclonal IgGκ cryoglobulin. Both patients presented with nephrotic syndrome, microscopic hematuria, and impaired renal function. Hepatitis C serology was negative, bone marrow aspiration was normal, and the renal biopsy specimen showed membranoproliferative glomerulonephritis with glomerular subendothelial deposits of monoclonal IgGκ. In both cases, circulating cryoglobulin and monotypic tissue deposits were found to be IgG3κ, suggesting that this isotype may have a particular propensity to cause this type of membranoproliferative glomerulonephritis. Although 18 cases of type I cryoglobulinemia with biopsy-proven glomerulonephritis have been reported to date, this is the first characterization of immunoglobulin heavy-chain isotype in this disease. Am J Kidney Dis 40:1091-1096. © 2002 by the National Kidney Foundation, Inc.