A case of membranoproliferative glomerulonephritis associated with curved fibril deposition.

Ikuyo Narita, Michiko Shimada, Takeshi Fujita, Reiichi Murakami, Masayuki Nakamura, Norio Nakamura, Hideaki Yamabe, Ken Okumura

BMC Nephrology 2015 September 16

BACKGROUND: It is sometimes challenging to diagnose unsusual cases of fibrillary glomerulonephritis (FGN) and immunotactoid glomerulopathy (ITG), the rare causes of nephrotic syndrome.

CASE PRESENTATION: A 75-year-old Japanese woman presented with nephrotic syndrome, microhematuria and renal insufficiency. Renal biopsy revealed membranoproliferative glomerulonephritis (MPGN) with IgM and weak C3 deposition. Congo red stain was negative. Electron microscopy demonstrated massive fibrils in the subendothelium, mesangium and subepithelium. The fibrils were partially parallel, partially curved and 17 nm in diameter. Cryoglobulin, hepatitis B virus (HBV) antigen, hepatitis C virus (HCV) antibody or antinuclear antibody were negative.

CONCLUSION: We report a case of MPGN associated with peculiar non-amyloid fibril deposition corresponding to neither FGN nor ITG.

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