A case of proliferative glomerulonephritis with large crescent formation in pregnancy with monoclonal IgG deposition
10.3760/cma.j.cn441217-20230425-00439
- VernacularTitle:妊娠合并单克隆IgG沉积的增生性肾小球肾炎伴大新月体形成1例
- Author:
Lina ZHANG
1
;
Juhong LIU
;
Jia LI
;
Beibei ZHANG
;
Jian GENG
;
Shunan WU
Author Information
1. 山西省长治市人民医院肾内科，长治 046000
- Keywords:
Immunoglobulin G;
Glomerulonephritis;
Pregnancy;
Crescent nephritis
- From:
Chinese Journal of Nephrology
2023;39(12):939-942
- CountryChina
- Language:Chinese
-
Abstract:
The patient was a young woman with a history of syphilis, gross hematuria onset, chronic course, exacerbation in the second and third trimesters. The clinical manifestations were gross hematuria, nephrotic syndrome, rapidly progressive glomerulonephritis requiring dialysis, decreased complement C3 and C4, and monoclonal IgG-kappa deposition in blood and urine immunofixation electrophoresis. Membranous proliferative glomerulonephritis with crescent formation under renal pathological light microscopy, only single IgG3 deposition in the immunofluorescent IgG subtype, and restrictive expression of light chain kappa, were diagnosed as proliferative glomerulonephritis with monoclonal IgG (IgG3-kappa) deposits (PGNMID). The was the first case with a history of syphilis that worsened during pregnancy. After treatment with bortezomib, cyclophosphamide, and dexamethasone, the patient was finally released from dialysis, renal function recovered, and proteinuria improved.
