Tuberculosis presenting as proliferative glomerulonephritis with monoclonal immunoglobulin deposits Tuberculosis que se presenta como glomerulonefritis proliferativa con depósitos de inmunoglobulina monoclonal


Helvacı Ö., ERTEN Y., Gönül İ. I. , ÖZET A., Hazneda R.

Revista de Nefrologia, Dialisis y Trasplante, vol.41, no.3, pp.202-206, 2021 (Journal Indexed in SCI Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 41 Issue: 3
  • Publication Date: 2021
  • Title of Journal : Revista de Nefrologia, Dialisis y Trasplante
  • Page Numbers: pp.202-206
  • Keywords: Membra-noproliferative glomerulonephritis, Monoclonal gammopathy of renal sig-nificance, Monoclonal gammopathy of undetermined significance, Proliferative glo-merulonephritis with monoclonal immunoglobulin deposits, Tuberculosis

Abstract

© 2021, Asociacion Regional de Dialisi y Transplantes Renales de Capital Federal y Provincia de Buenos Aires. All rights reserved.Proliferative glomerulonephritis with monoclonal immunoglobulin deposits is defined as membranoproliferative glomerulonephritis like injury with monotypic Ig deposits restricted to a single light chain isotype. Here we present a patient who presented with hypocomplementemia and nephrotic syndrome, who was initially diagnosed with proliferative glomerulonephritis with monoclonal immunoglobulin deposits. He developed disseminated tuberculosis after a brief course of immunosuppression. Successful treatment of tuberculosis resulted in the complete remission of glomerular disease and the disappearance of monoclonal protein. Hence, we believe he had Tuberculosis-related proliferative glomerulonephritis with monoclonal immunoglobulin deposits. Treatment strategies have not been structured due to the rarity of the condition and lack of randomized trials. However, expert opinion suggests clone-based therapy. proliferative glomerulonephritis with monoclonal immunoglobulin deposits with a benign course without clone-based therapy has been reported. Patients seldom respond to classic immunosuppressants. Even some cases experience slowly progressive disease under angiotensin converting enzyme inhibition alone. There are also cases secondary to viral infections. Our case and the particular “benign” cases lead us to an intriguing proposition that proliferative glomerulonephritis with monoclonal immunoglobulin deposits might not be a single disease. A subset of patients may be experiencing infection-related or post-infectious glomerulonephritis presenting as proliferative glomerulonephritis with monoclonal immunoglobulin deposits.