Abstract
PGNMID is a condition where monoclonal immunoglobulins (Ig) are deposited in the glomerulus. The culprit is most often IgG3κ. It is a novel form of glomerulonephritis (GN) that mimics immune-complex type GN on Light Microscopy (LM) and Electron Microscopy (EM); however by Immunofluorescence (IF) the glomerular deposits are monoclonal, staining for a single light-chain (LC) isotype and a single γ heavy-chain (HC) subclass, most commonly IgG3 κ. Diagnosis is based on renal biopsy finding of glomerular immune deposits staining positive for single heavy chain Ig indicating restriction to a single Ig class, positive staining for a single LC isotype indicating monoclonality and Electron Microscopy (EM) showing predominantly granular EDD (Electron Dense Deposits) in mesangial, subendothelial and/or subepithelial locations.
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