{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T04:54:57Z","timestamp":1781499297659,"version":"3.54.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","award":["2024JJ9570"],"award-info":[{"award-number":["2024JJ9570"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) is a rare glomerular disease characterized by edema, proteinuria, and renal insufficiency. No established treatment protocol is currently available. We report a case of PGNMID with monoclonal IgG1-\u03ba deposits in a patient with a 19-year history of type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 30-year-old woman presented with a 1-week history of nausea, vomiting, and generalized edema. She had a 19-year history of type 1 diabetes mellitus with poor glycemic control. Three months before admission, she had been hospitalized for fever and was diagnosed with a urinary tract infection, during which her renal function was normal. After discharge, she continued to experience recurrent episodes of fever. One week before admission, she gradually developed generalized edema accompanied by decreased urine output. On admission, she was found to have nephrotic-range proteinuria, hypoalbuminemia, anemia, acute renal failure, and acute heart failure. After antimicrobial therapy, renal replacement therapy, and nutritional support, the patient underwent renal biopsy. Immunofluorescence showed diffuse, global, granular, and lumpy deposits of IgG, C3, and \u03ba light chain along the glomerular capillary loops and in the mesangial regions, with strong IgG1 positivity. Electron microscopy revealed proliferation of glomerular capillary endothelial cells, accompanied by segmental mesangial matrix interposition into the basement membrane, resulting in a double-contour appearance. Segmental hump-like subepithelial electron-dense deposits were also observed. No abnormal monoclonal bands were detected by serum or urine immunofixation electrophoresis, and the serum and urine free light chain \u03ba\/\u03bb ratios were within the normal range. Bone marrow aspiration revealed 0.5% plasma cells. The final diagnosis was proliferative glomerulonephritis with monoclonal IgG1-\u03ba deposits (IgG1\u03ba-PGNMID). The patient was treated with prednisone, cyclophosphamide, and renal replacement therapy, with a good initial response. She was temporarily weaned from renal replacement therapy in the short term, but subsequently required long-term maintenance dialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with a long-standing history of diabetes, the presence of a preceding infection, hypocomplementemia, nephrotic-range proteinuria, and rapidly progressive renal dysfunction should prompt suspicion for non-diabetic kidney disease. In such cases, renal biopsy, together with serum and urine immunofixation electrophoresis, free light chain assays, complement testing, and rheumatologic autoantibody screening, is essential for the diagnosis and differential diagnosis of PGNMID and related disorders. For patients with confirmed PGNMID who lack clear evidence of monoclonality or decline targeted therapy, prednisone combined with cyclophosphamide may represent an effective alternative treatment option.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1799381","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T04:27:00Z","timestamp":1781497620000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Proliferative glomerulonephritis with monoclonal immunoglobulin IgG1-\u03ba deposition in a patient with type 1 diabetes: a case report and literature review"],"prefix":"10.3389","volume":"13","author":[{"given":"Xi","family":"Li","sequence":"first","affiliation":[{"name":"Heping Hospital Affiliated to Changzhi Medical College","place":["Changzhi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Heping Hospital Affiliated to Changzhi Medical College","place":["Changzhi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinjun","family":"Dai","sequence":"additional","affiliation":[{"name":"Liuyang Hospital of Traditional Chinese Medicine, The Second Western and Chinese Medicine Hospital of Hunan University of Chinese Medicine","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Third People\u2019s Hospital","place":["Taiyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Lan","sequence":"additional","affiliation":[{"name":"Liuyang Hospital of Traditional Chinese Medicine, The Second Western and Chinese Medicine Hospital of Hunan University of Chinese Medicine","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Li","sequence":"additional","affiliation":[{"name":"Liuyang Hospital of Traditional Chinese Medicine, The Second Western and Chinese Medicine Hospital of Hunan University of Chinese Medicine","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minghui","family":"Wu","sequence":"additional","affiliation":[{"name":"Liuyang Hospital of Traditional Chinese Medicine, The Second Western and Chinese Medicine Hospital of Hunan University of Chinese Medicine","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianhang","family":"Jia","sequence":"additional","affiliation":[{"name":"Xi\u2019an First Hospital","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Li","sequence":"additional","affiliation":[{"name":"Heping Hospital Affiliated to Changzhi Medical College","place":["Changzhi, China"]},{"name":"Liuyang Hospital of Traditional Chinese Medicine, The Second Western and Chinese Medicine Hospital of Hunan University of Chinese Medicine","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"344","DOI":"10.4103\/0971-4065.151354","article-title":"Proliferative glomerulonephritis with monoclonal immunoglobulin deposition disease: the utility of routine staining with immunoglobulin light chains.","volume":"25","author":"Gowda","year":"2015","journal-title":"Indian J Nephrol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1110","DOI":"10.1681\/ASN.2013070715","article-title":"Clinical findings, pathology, and outcomes of C3GN after kidney transplantation.","volume":"25","author":"Zand","year":"2014","journal-title":"J Am Soc Nephrol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2363","DOI":"10.1007\/s40620-022-01317-w","article-title":"Proliferative glomerulonephritis with monoclonal immunoglobulin deposits: an entity associated with distinct diseases and comparison between IgG1 and IgG3 subtypes.","volume":"35","author":"Liu","year":"2022","journal-title":"J Nephrol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1016\/j.ekir.2017.07.008","article-title":"Membranous glomerulopathy with light chain\u2013restricted deposits: a clinicopathological analysis of 28 Cases.","volume":"2","author":"Best Rocha","year":"2017","journal-title":"Kidney Intern Rep."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.2215\/CJN.10611110","article-title":"Patterns of noncryoglobulinemic glomerulonephritis with monoclonal Ig deposits: correlation with IgG subclass and response to rituximab.","volume":"6","author":"Guiard","year":"2011","journal-title":"Clin J Am Soc Nephrol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.1681\/ASN.2020101541","article-title":"Safety and efficacy of daratumumab in patients with proliferative GN with monoclonal immunoglobulin deposits.","volume":"32","author":"Zand","year":"2021","journal-title":"JASN."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e029565","DOI":"10.1161\/JAHA.122.029565","article-title":"Updates for cardio-kidney protective effects by angiotensin receptor-neprilysin inhibitor: requirement for additional evidence of kidney protection.","volume":"12","author":"Tsukamoto","year":"2023","journal-title":"JAHA."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1161\/CIRCULATIONAHA.120.047643","article-title":"Angiotensin-Neprilysin inhibition and renal outcomes in heart failure with preserved ejection fraction.","volume":"142","author":"Mc Causland","year":"2020","journal-title":"Circulation."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e2429237","DOI":"10.1001\/jamanetworkopen.2024.29237","article-title":"Sacubitril-Valsartan in patients requiring hemodialysis.","volume":"7","author":"Le","year":"2024","journal-title":"JAMA Netw Open."},{"key":"B10","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1111\/j.1523-1755.2004.00365.x","article-title":"Proliferative glomerulonephritis with monoclonal IgG deposits: a distinct entity mimicking immune-complex glomerulonephritis.","volume":"65","author":"Nasr","year":"2004","journal-title":"Kidney Intern."},{"key":"B11","unstructured":"Three cases of proliferative glomerulonephritis with monoclonal immunoglobulin deposition.\n          \n          E0194\n          \n            \n              Lu\n              L\n            \n            \n              Yang\n              L\n            \n            \n              Dong\n              B\n            \n            \n              Jin\n              L.\n            \n          \n          Chin. Med. Case Reposit.\n          6\n          2024"},{"key":"B12","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1097\/MNH.0000000000000201","article-title":"Spectrum of manifestations of monoclonal gammopathy-associated renal lesions.","volume":"25","author":"Sethi","year":"2016","journal-title":"Curr Opin Nephrol Hypertens."},{"key":"B13","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1136\/jcp-2023-208795","article-title":"Light chain only variant of proliferative glomerulonephritis with monoclonal immunoglobulin deposits: a clinicopathological study of three cases.","volume":"77","author":"Liang","year":"2024","journal-title":"J Clin Pathol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/j.mayocp.2015.01.024","article-title":"Hematologic characteristics of proliferative glomerulonephritides with nonorganized monoclonal immunoglobulin deposits.","volume":"90","author":"Bhutani","year":"2015","journal-title":"Mayo Clin Proc."},{"key":"B15","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1007\/s00467-002-1056-2","article-title":"Nephrotic syndrome associated with human parvovirus B19 infection.","volume":"18","author":"Ohtomo","year":"2003","journal-title":"Pediatr Nephrol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"e243061","DOI":"10.1136\/bcr-2021-243061","article-title":"Proliferative glomerulonephritis with monoclonal immunoglobulin deposits associated with parvovirus B19.","volume":"14","author":"Santana De Roberts","year":"2021","journal-title":"BMJ Case Rep."},{"key":"B17","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1007\/s00467-020-04763-5","article-title":"Progression of proliferative glomerulonephritis with monoclonal IgG deposits in pediatric patients.","volume":"36","author":"Miller","year":"2021","journal-title":"Pediatr Nephrol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1007\/s44313-024-00027-5","article-title":"Monoclonal gammopathy of renal significance from the perspective of nephrologists.","volume":"59","author":"Park","year":"2024","journal-title":"Blood Res."},{"key":"B19","doi-asserted-by":"publisher","first-page":"e70088","DOI":"10.1002\/ccr3.70088","article-title":"A case report of membranoproliferative glomerulonephritis: infection-related or immune-related?","volume":"13","author":"Azhary","year":"2025","journal-title":"Clin Case Rep."},{"key":"B20","doi-asserted-by":"publisher","first-page":"e674","DOI":"10.1016\/j.clml.2021.04.011","article-title":"Treatment of monoclonal gammopathy-associated C3 glomerulopathy with daratumumab-based therapy.","volume":"21","author":"Coltoff","year":"2021","journal-title":"Clin Lymphoma Myeloma Leukemia."},{"key":"B21","doi-asserted-by":"publisher","first-page":"2128","DOI":"10.1093\/ndt\/gfab302","article-title":"C3 glomerulopathy associated with monoclonal gammopathy: impact of chronic histologic lesions and beneficial effects of clone-targeted therapies.","volume":"37","author":"Caravaca-Font\u00e1n","year":"2022","journal-title":"Nephrol Dial Transplant."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1182\/blood-2016-08-737163","article-title":"Treatment of B-cell disorder improves renal outcome of patients with monoclonal gammopathy\u2013associated C3 glomerulopathy.","volume":"129","author":"Chauvet","year":"2017","journal-title":"Blood."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1587","DOI":"10.1016\/S0140-6736(25)01148-1","article-title":"Oral iptacopan therapy in patients with C3 glomerulopathy: a randomised, double-blind, parallel group, multicentre, placebo-controlled, phase 3 study.","volume":"406","author":"Kavanagh","year":"2025","journal-title":"Lancet."},{"key":"B24","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1016\/j.ekir.2024.10.023","article-title":"Iptacopan reduces proteinuria and stabilizes kidney function in C3 glomerulopathy.","volume":"10","author":"Nester","year":"2024","journal-title":"Kidney Int Rep."},{"key":"B25","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1053\/j.ajkd.2025.01.009","article-title":"IgM variant of proliferative glomerulonephritis with monoclonal immunoglobulin deposits: a case series.","volume":"85","author":"Bu","year":"2025","journal-title":"Am J Kidney Dis."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1799381\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T04:27:06Z","timestamp":1781497626000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1799381\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":25,"alternative-id":["10.3389\/fmed.2026.1799381"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1799381","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]},"article-number":"1799381"}}