Recurrent IgA1-λ-Type PGNMID Achieving Remission with Conventional Immunosuppressive Therapy

Kazuki Chida; Atsushi Oura; Tasuku Takahashi; Machi Kiyohara; Kaho Matsumoto; Tetsuya Kyo; Yusuke Ishizuka; Hitomi Kamei; Yuki Nakamura; Izaya Nakaya

doi:10.2169/internalmedicine.6357-25

CASE REPORTS

Recurrent IgA1-λ-Type PGNMID Achieving Remission with Conventional Immunosuppressive Therapy

Kazuki Chida, Atsushi Oura, Tasuku Takahashi, Machi Kiyohara, Kaho Matsumoto, Tetsuya Kyo, Yusuke Ishizuka, Hitomi Kamei, Yuki Nakamura, Izaya Nakaya

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Keywords: clone-directed therapy, IgA-type PGNMID, immunosuppressive therapy, monoclonal gammopathy of renal significance, proliferative glomerulonephritis with monoclonal immunoglobulin deposits

JOURNAL OPEN ACCESS

2026 Volume 65 Issue 12 Pages 1650-1656

DOI https://doi.org/10.2169/internalmedicine.6357-25

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Abstract

A 58-year-old man was admitted to our hospital in April 2013 with elevated serum creatinine levels, proteinuria, and hematuria. A renal biopsy revealed membranoproliferative glomerulonephritis-like changes. Immunofluorescence showed IgA1 and λ light chain deposits along the capillary walls, confirming IgA-λ type proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID). Complete remission was achieved with glucocorticoid monotherapy in December 2013. After a relapse in April 2021, immunosuppressive treatment, including intravenous cyclophosphamide and subsequent mycophenolate mofetil, led to a complete remission. This case indicates that conventional immunosuppressive therapy may be effective for IgA-type PGNMID.

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