Two Cases of IgG-associated Mesangial Glomerulonephritis in Children

Lee, Sang-Hoo; Kim, Pyung-Kil; Song, Ji-Sun

doi:2008.12.1.93

J Korean Soc Pediatr Nephrol > Volume 12(1); 2008 > Article

J Korean Soc Pediatr Nephrol 2008;12(1): 93-98. doi: https://doi.org/10.3339/jkspn.2008.12.1.93

소아에서 관찰된 IgG-associated mesangial glomerulonephritis 2례

이상후, 김병길, 송지선

¹관동대학교 의과대학 소아과학교실
²관동대학교 의과대학 소아과학교실
³관동대학교 의과대학 병리학교실

Two Cases of IgG-associated Mesangial Glomerulonephritis in Children

Sang-Hoo Lee, Pyung-Kil Kim, Ji-Sun Song

¹Department of Pediatrics Kwandong University College of Medicine
²Department of Pediatrics Kwandong University College of Medicine
³Department of Pathology Kwandong University College of Medicine

ABSTRACT

Rare cases of IgG associated mesangial glomerulonephritis(IgG GN) defined by exclusive or predominant mesangial IgG deposits were reported first by Sato et al.(1993). and subsequently 10 pediatric cases were reported by Yoshikawa et al.(1994). Previous reports suggested that the prognosis of IgG GN is relatively benign course but recent report suggested that prognosis of IgG GN is highly variable. Also the recurrence of IgG GN in a renal transplant was reported by Fakhouri et al. (2002). Such a recurrence highlights the specificity of this type of glomerulonephritis. We experienced two pediatric cases of IgG GN proven by renal biopsy. Case 1. 4-year-old girl with nephrotic syndrome admitted because of general edema. The patient's urinalysis showed proteinuria and microscopic hematuria. Renal biopsy was performed because of relapsed nephritic syndrome. Light microscopic finding was nonspecific with almost normal histology. Immunofluorescent findings showed diffuse segmental IgG(+) and IgM(+) deposits in the capillary walls, and focal segmental spotty C4(trace), C1q(trace) deposits. Electron microscopic findings showed focal portion of mesangial electron dense deposits without mesangial widening. Case 2. 11-year-old girl admitted for evaluation of microsopic hematuria detected through mass school urinary screening program. Renal biopsy was performed for exact diagnosis. Immunofluorescent findings showed focal segmental IgG(+), IgM(+/-) and C3(+/-) deposits. Electron microscopic findings showed focal portion of mesangial electron dense deposits without mesangial widening.

Key words: IgG associated mesangial glomerulonephritis | Nephrotic syndrome