{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T12:35:17Z","timestamp":1778934917377,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2016,6,24]],"date-time":"2016-06-24T00:00:00Z","timestamp":1466726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Immunoglobulin (Ig) A nephropathy (IgAN) is a known autoimmune disease due to abnormal glycosylation of IgA1, and occasionally, IgG co\u2010deposition occurs. The prognosis of IgG co\u2010deposition with IgAN is adverse, as shown in the previous studies. However, in the clinical setting, monoclonality of IgG co\u2010deposition with IgAN has not been observed. We describe a case of proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) combined with IgAN in a renal allograft. A\u201021\u2010year\u2010old man developed end\u2010stage renal failure with unknown aetiology and underwent living\u2010donor kidney transplantation from his mother 2\u2009years after being diagnosed. One year after kidney transplantation, proteinuria 2+ and haematuria 2+ were detected; allograft biopsy revealed mesangial IgA and C3 deposits, indicating a diagnosis of IgAN. After tonsillectomy and steroid pulse therapy, proteinuria and haematuria resolved. However, 4\u2009years after transplantation, pedal oedema, proteinuria (6.89\u2009g\/day) and allograft dysfunction (serum creatinine (sCr) 203.3\u2009\u00b5mol\/L) appeared. A second allograft biopsy showed mesangial expansion and focal segmental proliferative endocapillary lesions with IgA1\u03bb and monoclonal IgG1\u03ba depositions. Electron microscopic analysis revealed a massive amount of deposits, located in the mesangial and subendothelial lesions. A diagnosis of PGNMID complicated with IgAN was made, and rituximab and plasmapheresis were added to steroid pulse therapy. With this treatment, proteinuria was alleviated to 0.5\u2009g\/day, and the allograft dysfunction recovered to sCr 132.6\u2009\u00b5mol\/L. This case suggests a necessity for investigation of PGNMID and IgA nephropathy in renal allografts to detect monoclonal Ig deposition disease.<\/jats:p>","DOI":"10.1111\/nep.12775","type":"journal-article","created":{"date-parts":[[2016,3,14]],"date-time":"2016-03-14T06:34:50Z","timestamp":1457937290000},"page":"48-52","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Proliferative glomerulonephritis with monoclonal immunoglobulin G deposits complicated by immunoglobulin A nephropathy in the renal allograft"],"prefix":"10.1111","volume":"21","author":[{"given":"Anri","family":"Sawada","sequence":"first","affiliation":[{"name":"Department of Surgical Pathology  Tokyo Japan"},{"name":"Department of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunio","family":"Kawanishi","sequence":"additional","affiliation":[{"name":"Department of Surgical Pathology  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeru","family":"Horita","sequence":"additional","affiliation":[{"name":"Division of Pathology, Kidney Center Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junki","family":"Koike","sequence":"additional","affiliation":[{"name":"Department of Pathology Kawasaki Municipal Tama Hospital  Kawasaki Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuho","family":"Honda","sequence":"additional","affiliation":[{"name":"Department of Anatomy Showa University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayami","family":"Ochi","sequence":"additional","affiliation":[{"name":"Department of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mizuki","family":"Komoda","sequence":"additional","affiliation":[{"name":"Department of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoichiro","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohei","family":"Unagami","sequence":"additional","affiliation":[{"name":"Department of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayoshi","family":"Okumi","sequence":"additional","affiliation":[{"name":"Department of Urology  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomokazu","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Urology  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Urology  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazunari","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Urology  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoji","family":"Nagashima","sequence":"additional","affiliation":[{"name":"Department of Surgical Pathology  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kosaku","family":"Nitta","sequence":"additional","affiliation":[{"name":"Department of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,6,24]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1206793"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfg373"},{"key":"e_1_2_5_4_1","first-page":"694","article-title":"Intercapillary deposits of IgA\u2010IgG","volume":"74","author":"Berger J","year":"1968","journal-title":"J. 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