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CASI CLINICI – Case Reports

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Biochimica Clinica 2015; 39(6) e22-e24

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Un caso di gammopatia monoclonale di significato renale in un paziente con glomerulopatia immunotattoide

AUTORI

Alessandro Terreni1, Franco Bergesio2, Elisa Buti2, Margherita Berardi1, Egrina Dervishi2, Chiara Nozzoli3,
Konstantinos Giannakakis4, Anna Caldini1
1Laboratorio Generale
2Nefrologia e Dialisi
3Ematologia, Azienda Ospedaliero-Universitaria Careggi, Firenze
4Dipartimento di Patologia, Università La Sapienza, Roma

ABSTRACT

A case of monoclonal gammopathy of renal significance in a patient affected by immunotactoid glomerulopathy

Monoclonal gammopathy of renal significance is defined by the causal relationship between a small B-cell clone and the renal disease. Immunotactoid glomerulopathy is a rare glomerular disease characterized by
highly organized crystalline structure of Congo Red-negative immune deposits in the absence of systemic disease. We describe a 54 years-old man with non-nephrotic proteinuria and chronic renal failure. Laboratory findings revealed a serum monoclonal component. Renal histology showed a morphological pattern of membrano-proliferative glomerulonephritis; electron microscopy evidenced micro tubular structures within the mesangium measuring approximately 20 nm in thickness, similar to cryoglobulins. Renal immunofluorescence demonstrated in the deposits the same monoclonal component observed in serum, leading to a final diagnosis of immunotactoid glomerulopathy.

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