Recurrence of monoclonal IgA lambda glomerulonephritis in kidney allograft associated with multiple myeloma

Sandra Herrmann, Mahendra V. Govani, Mary E. Fidler, Samih H. Nasr, Daniel Klink, Chirag Amin, Nelson Leung, Fernando Custodio Fervenza

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) has been described as a new entity resembling immune-complex glomerulonephritis (GN). The recurrence of proliferative GN with monoclonal IgG in the renal allograft has been reported. However, recurrence of proliferative GN with monoclonal IgA after renal allograft is undefined. We previously reported a case of a 35-year-old woman with proliferative glomerulonephritis with monoclonal lambda (λ) with mesangial and subendothelial paracrystalline deposits in the native kidney and initially undetectable circulating monoclonal protein or clone by bone marrow biopsy or flow cytometry. Despite immunosuppressive therapy, her renal disease progressed to end-stage of renaldisease (ESRD) and the patient ultimately received a renal allograft. Transplantation was followed by recurrence of IgA-λ PGNMID 4 months after renal transplantation and was associated the diagnosis of multiple myeloma. To the best of our knowledge recurrence of IgA PGNMID with paracrystalline deposits has not been previously reported.

Original languageEnglish (US)
Pages (from-to)241-246
Number of pages6
JournalClinical Nephrology
Volume84
Issue number4
DOIs
StatePublished - 2015

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Keywords

  • Crystals
  • Glomerulonephritis
  • IgA
  • Monoclonal
  • Multiple myeloma
  • Renal transplant recurrence

ASJC Scopus subject areas

  • Nephrology

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