Cryofibrinogen-associated glomerulonephritis diagnosed by mass spectrometry and immunoelectron microscopy
A 60-year-old male presented with accelerated hypertension, renal insufficiency, proteinuria, and hematuria. Percutaneous kidney biopsy revealed membranoproliferative glomerulonephritis (MPGN) without any immunoglobulin and complement deposition. On performing electron microscopy, deposits with a tu...
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doaj-194cfa13c40d4001a749dd5e3bbb9f652020-11-25T00:44:24ZengElsevierHuman Pathology: Case Reports2214-33002019-03-01158387Cryofibrinogen-associated glomerulonephritis diagnosed by mass spectrometry and immunoelectron microscopyMasanori Sudo0Yuichi Sakamaki1Michihiro Hosojima2Suguru Yamamoto3Yumi Ito4Naofumi Imai5Yoshikatsu Kaneko6Shin Goto7Chih-Ping Li8Akira Shimizu9Ichiei Narita10Division of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan; Corresponding author at: Division of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachidori, Chuo-ku, Niigata-shi, Niigata 951-8510, Japan.Division of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, JapanDepartment of Clinical Nutrition Science, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, JapanDivision of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, JapanDivision of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, JapanDivision of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, JapanDivision of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, JapanDivision of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, JapanDepartment of Pathology, Saitama Medical University, Saitama 350-0495, JapanDepartment of Analytic Human Pathology, Nippon Medical School, Tokyo 113-8602, JapanDivision of Clinical Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, JapanA 60-year-old male presented with accelerated hypertension, renal insufficiency, proteinuria, and hematuria. Percutaneous kidney biopsy revealed membranoproliferative glomerulonephritis (MPGN) without any immunoglobulin and complement deposition. On performing electron microscopy, deposits with a tubular, organized structure and approximately 60 nm in diameter were detected in the glomerular subendothelial spaces and mesangial areas. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) demonstrated the significantly increased deposition of fibrinogen and fibronectin in glomeruli. Immunohistochemistry and immunoelectron microscopy demonstrated that the deposits were composed of fibrinogen. Here we report a case of cryofibrinogen -associated GN in which LC-MS/MS and immunoelectron microscopy were useful for diagnosis. When MPGN with organized deposits without the deposition of immunoglobulins and complements is diagnosed, we considered the cryofibrinogen-associated GN in one of the differential diagnosis, and even skin symptoms cannot be detected. Keywords: Cryofibrinogen-related kidney disease, Liquid chromatography-tandem mass spectrometry, Immunoelectron microscopyhttp://www.sciencedirect.com/science/article/pii/S2214330018301305 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Masanori Sudo Yuichi Sakamaki Michihiro Hosojima Suguru Yamamoto Yumi Ito Naofumi Imai Yoshikatsu Kaneko Shin Goto Chih-Ping Li Akira Shimizu Ichiei Narita |
spellingShingle |
Masanori Sudo Yuichi Sakamaki Michihiro Hosojima Suguru Yamamoto Yumi Ito Naofumi Imai Yoshikatsu Kaneko Shin Goto Chih-Ping Li Akira Shimizu Ichiei Narita Cryofibrinogen-associated glomerulonephritis diagnosed by mass spectrometry and immunoelectron microscopy Human Pathology: Case Reports |
author_facet |
Masanori Sudo Yuichi Sakamaki Michihiro Hosojima Suguru Yamamoto Yumi Ito Naofumi Imai Yoshikatsu Kaneko Shin Goto Chih-Ping Li Akira Shimizu Ichiei Narita |
author_sort |
Masanori Sudo |
title |
Cryofibrinogen-associated glomerulonephritis diagnosed by mass spectrometry and immunoelectron microscopy |
title_short |
Cryofibrinogen-associated glomerulonephritis diagnosed by mass spectrometry and immunoelectron microscopy |
title_full |
Cryofibrinogen-associated glomerulonephritis diagnosed by mass spectrometry and immunoelectron microscopy |
title_fullStr |
Cryofibrinogen-associated glomerulonephritis diagnosed by mass spectrometry and immunoelectron microscopy |
title_full_unstemmed |
Cryofibrinogen-associated glomerulonephritis diagnosed by mass spectrometry and immunoelectron microscopy |
title_sort |
cryofibrinogen-associated glomerulonephritis diagnosed by mass spectrometry and immunoelectron microscopy |
publisher |
Elsevier |
series |
Human Pathology: Case Reports |
issn |
2214-3300 |
publishDate |
2019-03-01 |
description |
A 60-year-old male presented with accelerated hypertension, renal insufficiency, proteinuria, and hematuria. Percutaneous kidney biopsy revealed membranoproliferative glomerulonephritis (MPGN) without any immunoglobulin and complement deposition. On performing electron microscopy, deposits with a tubular, organized structure and approximately 60 nm in diameter were detected in the glomerular subendothelial spaces and mesangial areas. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) demonstrated the significantly increased deposition of fibrinogen and fibronectin in glomeruli. Immunohistochemistry and immunoelectron microscopy demonstrated that the deposits were composed of fibrinogen. Here we report a case of cryofibrinogen -associated GN in which LC-MS/MS and immunoelectron microscopy were useful for diagnosis. When MPGN with organized deposits without the deposition of immunoglobulins and complements is diagnosed, we considered the cryofibrinogen-associated GN in one of the differential diagnosis, and even skin symptoms cannot be detected. Keywords: Cryofibrinogen-related kidney disease, Liquid chromatography-tandem mass spectrometry, Immunoelectron microscopy |
url |
http://www.sciencedirect.com/science/article/pii/S2214330018301305 |
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