Characteristic electron-microscopic features of cryofibrinogen-associated glomerulonephritis: a case report.

Abstract:

BACKGROUND:Cryofibrinogenemia is a rare disorder that mainly affects the skin and occasionally the kidney. However, there are few published reports of cryofibrinogenemia-associated renal pathology. We therefore report a patient with cryofibrinogen-associated glomerulonephritis. Samples from this patient were examined by electron microscopy, laser microdissection, and liquid chromatography-tandem mass spectrometry (LC-MS/MS). CASE PRESENTATION:A 78-year-old Japanese man presented with declining renal function, proteinuria, and gross hematuria. Kidney biopsy showed a membranoproliferative pattern with crescent formation and dominant C3c deposition in which subendothelial deposits with uniquely organized electron-microscopic features were observed. Additional ultrastructural analysis of cryoprecipitates extracted from plasma revealed similar structures of the glomerular subendothelial deposits. LC-MS/MS identified an increase in fibrinogen α, β, and γ chains, fibronectin, filamin-A, and C3. The glomerular lesions were diagnosed as cryofibrinogen-associated glomerulonephritis on the basis of these findings. CONCLUSIONS:Although there are few reports of cryofibrinogen-associated glomerulonephritis, we believe that accurate diagnosis can be achieved by performing LC-MS/MS and ultrastructural analysis.

journal_name

BMC Nephrol

journal_title

BMC nephrology

authors

Ibuki E,Shiraishi A,Sofue T,Kushida Y,Kadota K,Honda K,Kang D,Joh K,Minamino T,Haba R

doi

10.1186/s12882-020-1696-0

subject

Has Abstract

pub_date

2020-01-29 00:00:00

pages

27

issue

1

issn

1471-2369

pii

10.1186/s12882-020-1696-0

journal_volume

21

pub_type

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