Abstract
Aims To document a previously unreported association of chronic lithium nephrotoxicity and proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID). Methods A 70-year-old female with a long-term history of lithium treatment for bipolar disorder presented with the nephrotic syndrome. A renal biopsy was performed. Results A chronic tubulo-interstitial nephritis with microcysts was present, typical of lithium toxicity. The glomeruli showed a membranoproliferative glomerulonephritis with mesangial and granular capillary loop reactivity for C3, IgG and kappa (but not lambda) light chain. Electron microscopy confirmed mesangial and subendothelial deposits which lacked microtubular and fibril-lary features. Cryoglobulins were not detected. Discussion Lithium treatment can cause the nephrotic syndrome, but usually due to minimal change nephropathy or focal segmen-tal glomerulosclerosis. An association with PGNMID has not been described in the literature, and is probably coincidental.
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