Progression of proliferative glomerulonephritis with monoclonal IgG deposits in pediatric patients

Miller, Paul L.; Xiao, Andrew Y.; Kung, Vanderlene L.; Sibley, Richard K.; Higgins, Julian P T; Kambham, Neeraja; Charu, Vivek; Lenihan, Colin R.; Uber, Amanda M; Talley, Elizabeth M.; Arora, Neiha; Walavalkar, Vighnesh; Lászik, Zoltán; Nast, Cynthia C.; Troxell, Megan L.

doi:10.1007/s00467-020-04763-5

Cited by 17 publications

(12 citation statements)

References 15 publications

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“…39 Interestingly, a recent report describes 9 pediatric cases of IgG-PGNMID who showed IgG3 subclass restriction of kidney deposited material, often with lambda light chain isotype. 40 No serum monoclonal Ig was detected by conventional methods in all tested patients. Of note, previous or concurrent infections by group A streptococcus, influenza B virus or other undetermined pathogen, were observed in 5 cases, suggesting a mechanism of adaptive immune response to infectious pathogens in disease pathogenesis.…”

Section: Proliferative Glomerulonephritis With Mono-isotypic Ig Deposition (Pgnmid)mentioning

confidence: 86%

A Fresh Perspective on Monoclonal Gammopathies of Renal Significance

Aucouturier

D’Agati

Ronco

2021

Kidney International Reports

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Proliferative Glomerulonephritis With Mono-isotypic Ig Deposition (Pgnmid)mentioning

confidence: 86%

A Fresh Perspective on Monoclonal Gammopathies of Renal Significance

Aucouturier

D’Agati

Ronco

2021

Kidney International Reports

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“…There have also been several reported cases of PGNMID that were associated with infection, including PVB19 ( 8 , 19 ) or corona virus disease 2019 ( 20 ). More intriguingly, preceding or concurrent infection was identified in more than half of the pediatric patients with PGNMID ( 21 ). Thus, infection could be deeply involved in the pathogenesis of PGNMID, more than previously considered.…”

Section: Discussionmentioning

confidence: 99%

Proliferative glomerulonephritis with monoclonal immunoglobulin G3 lambda deposits accompanied by glomerular positive staining for nephritis-associated plasmin receptor and related plasmin activity: A report of two cases

Uchida

Oda²,

Hoshino³

et al. 2023

Front. Med.

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Proliferative glomerulonephritis with monoclonal immunoglobulin (Ig) G deposits (PGNMID) is a relatively uncommon entity of monoclonal gammopathy of renal significance, and its detailed pathogenesis is not well understood. We, herein, report two cases of patients with PGNMID; their renal biopsy showed glomerular histological features of membranoproliferative glomerulonephritis pattern with endocapillary proliferation accompanied by non-organized granular electron-dense deposits that consisted of monoclonal IgG3-lambda. Neither symptomatic episodes of preceding infection nor infection foci were found in both patients; however, glomerular positive staining for nephritis-associated plasmin receptor (NAPlr) and related plasmin activity were observed. Although NAPlr was originally considered as a candidate nephritogenic protein for post-streptococcal acute glomerulonephritis, its positive staining and related plasmin activity have been observed in glomeruli of various cases with bacterial infection-related glomerulonephritis and is considered to be a general histological biomarker of infection-related glomerulonephritis. The present cases suggest that evaluation of immunoreactivity for NAPlr and related plasmin activity in glomeruli provides an important clue regarding the infection-related pathogenesis of PGNMID.

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“…14,17,18 In addition, spontaneous remission of PGNMID patients that occurs at a young age or after viral infection may suggest that pathogenesis also involves induction of B-cell repertoires by viral or other antigenic stimulation mechanisms, producing low clonal nephrotoxic IgG3. [19][20][21][22]…”

Section: Pathogenesismentioning

confidence: 99%

A Review on the Diagnosis and Treatment of Proliferative Glomerulonephritis with Monoclonal Immunoglobulin Deposits

Li¹,

Chen²

2022

IJGM

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Proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) is a new entity of monoclonal gammopathy of renal significance (MGRS) due to monoclonal immunoglobulin (mIg) deposits in the glomerulus leading to kidney injury. Patients with PGNMID typically present with proteinuria, haematuria, and abnormal renal function. Only ~30% of patients have a detectable clone in the blood, urine or bone marrow. Histologically, the membranoproliferative glomerulonephritis (MPGN) pattern of injury is the most common, with approximately 50% of patients demonstrating IgG3κ monoclonal deposition in the glomerulus. Approximately 20% of PGNMID patients progress to end-stage kidney disease (ESΚD), and recurrence with renal allograft is frequent. Treatment of PGNMID relies on targeting identifiable B-cell or plasma cell clones. Due to the relatively short history of research on this disease and incomplete understanding, it is easy to misdiagnose and miss diagnosis, and there are also objections on how to treat it. Therefore, we review the development of PGNMID understanding in the past 20 years and discuss this new entity from a holistic and progressive perspective.

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Progression of proliferative glomerulonephritis with monoclonal IgG deposits in pediatric patients

Cited by 17 publications

References 15 publications

A Fresh Perspective on Monoclonal Gammopathies of Renal Significance

A Fresh Perspective on Monoclonal Gammopathies of Renal Significance

Proliferative glomerulonephritis with monoclonal immunoglobulin G3 lambda deposits accompanied by glomerular positive staining for nephritis-associated plasmin receptor and related plasmin activity: A report of two cases

A Review on the Diagnosis and Treatment of Proliferative Glomerulonephritis with Monoclonal Immunoglobulin Deposits

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