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. 1977 Jul;88(1):145–162.

Ultrastructure in glomerulonephritis associated with cryoglobulinemia. A report of six cases and review of the literature.

H Feiner, G Gallo
PMCID: PMC2032161  PMID: 879268

Abstract

Renal tissue from 6 patients with glomerulonephritis associated with cryoglobulinemia was studied by light microscopy, immunofluorescence microscopy, and electron microscopy. Fibrillar deposits in glomerular capillaries were observed in electron micrographs in 4 of 6 patients. The ultrastructure of these deposits is compared with those in 6 previously reported cases, with the ultrastructure of the serum cryoprecipitates, and with fibrillar glomerular deposits in other glomerulonephritides. It is concluded that serum cryoprecipitates are structurally similar to glomerular deposits and that these fibrillar deposits are a frequent and possibly distinguishing morphologic feature of glomerulonephritis associated with cryoglobulinemia.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adam C., Morel-Maroger L., Richet G. Cryoglobulins in glomerulonephritis not related to systemic disease. Kidney Int. 1973 May;3(5):334–341. doi: 10.1038/ki.1973.52. [DOI] [PubMed] [Google Scholar]
  2. Bartlow B. G., Oyama J. H., Ing T. S., Miller A. W., Economou S. G., Rennie I. D., Lewis E. J. Glomerular ultrastructural abnormalities in a patient with mixed IgG-IgM essential cryoglobulinemic glomerulonephritis. Nephron. 1975;14(3-4):309–319. doi: 10.1159/000180461. [DOI] [PubMed] [Google Scholar]
  3. Bengtsson U., Larsson O., Lindstedt G., Svalander C. Monoclonal IgG cryoglobulinemia with secondary development of glomerulonephritis and nephrotic syndrome. Q J Med. 1975 Jul;44(175):491–503. [PubMed] [Google Scholar]
  4. Bogaars H. A., Kalderon A. E., Cummings F. J., Kaplan S., Melnicoff I., Park C., Diamond I., Calabresi P. Human IgG cryoglobulin with tubular crystal structure. Nat New Biol. 1973 Sep 26;245(143):117–118. doi: 10.1038/newbio245117a0. [DOI] [PubMed] [Google Scholar]
  5. Brouet J. C., Clauvel J. P., Danon F., Klein M., Seligmann M. Biologic and clinical significance of cryoglobulins. A report of 86 cases. Am J Med. 1974 Nov;57(5):775–788. doi: 10.1016/0002-9343(74)90852-3. [DOI] [PubMed] [Google Scholar]
  6. CHRISTIAN C. L., HATFIELD W. B., CHASE P. H. Systemic lupus erythematosus. Cryoprecipitation of sera. J Clin Invest. 1963 Jun;42:823–829. doi: 10.1172/JCI104774. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cordonnier D., Martin H., Groslambert P., Micouin C., Chenais F., Stoebner P. Mixed IgG-IgM cryoglobulinemia with glomerulonephritis. Immunochemical, fluorescent and ultrastructural study of kidney and in vitro cryoprecipitate. Am J Med. 1975 Dec;59(6):867–872. doi: 10.1016/0002-9343(75)90480-5. [DOI] [PubMed] [Google Scholar]
  8. Davis B. K., Cavallo T. Membranoproliferative glomerulonephritis. Localization of early components of complement in glomerular deposits. Am J Pathol. 1976 Aug;84(2):283–298. [PMC free article] [PubMed] [Google Scholar]
  9. Druet P., Letonturier P., Contet A., Mandet C. Cryoglobulinaemia in human renal diseases. A study of seventy-six cases. Clin Exp Immunol. 1973 Dec;15(4):483–496. [PMC free article] [PubMed] [Google Scholar]
  10. Farivar M., Wands J. R., Benson G. D., Dienstag J. L., Isselbacher K. J. Cryoprotein complexes and peripheral neuropathy in a patient with chronic active hepatitis. Gastroenterology. 1976 Sep;71(3):490–493. [PubMed] [Google Scholar]
  11. Feizi T., Gitlin N. Immune-complex disease of the kidney associated with chronic hepatitis and cryoglobulinaemia. Lancet. 1969 Oct 25;2(7626):873–876. doi: 10.1016/s0140-6736(69)92329-0. [DOI] [PubMed] [Google Scholar]
  12. Golde D., Epstein W. Mixed cryoglobulins and glomerulonephritis. Ann Intern Med. 1968 Dec;69(6):1221–1227. doi: 10.7326/0003-4819-69-6-1221. [DOI] [PubMed] [Google Scholar]
  13. Grishman E., Porush J. C., Rosen S. M., Churg J. Lupus nephritis with organized deposits in the kidneys. Lab Invest. 1967 May;16(5):717–725. [PubMed] [Google Scholar]
  14. Grupe W. E. IgG-B1C cryoglobulins in acute glomerulonephritis. Pediatrics. 1968 Sep;42(3):474–482. [PubMed] [Google Scholar]
  15. Knieser M. R., Jenis E. H., Lowenthal D. T., Bancroft W. H., Burns W., Shalhoub R. Pathogenesis of renal disease associated with viral hepatitis. Arch Pathol. 1974 Apr;97(4):193–200. [PubMed] [Google Scholar]
  16. Mathison D. A., Condemi J. J., Leddy J. P., Callerame M. L., Panner B. J., Vaughan J. H. Purpura, arthralgia, and IgM-IgM cryoglobulinemia with rheumatoid factor acrivity. Response to cyclophosphamide and splenectomy. Ann Intern Med. 1971 Mar;74(3):383–390. doi: 10.7326/0003-4819-74-3-383. [DOI] [PubMed] [Google Scholar]
  17. McIntosh R. M., Kaufman D. B., Kulvinskas C., Grossman B. J. Cryoglobulins. I. Studies on the nature, incidence, and clinical significance of serum cryoproteins in glomerulonephritis. J Lab Clin Med. 1970 Apr;75(4):566–577. [PubMed] [Google Scholar]
  18. Meltzer M., Franklin E. C., Elias K., McCluskey R. T., Cooper N. Cryoglobulinemia--a clinical and laboratory study. II. Cryoglobulins with rheumatoid factor activity. Am J Med. 1966 Jun;40(6):837–856. doi: 10.1016/0002-9343(66)90200-2. [DOI] [PubMed] [Google Scholar]
  19. Monga G., Mazzucco G., Coppo R., Piccoli G., Coda R. Glomerular findings in mixed IgG-IgM cryoglobulinemia. Light, electron microscopic, immunofluorescence and histochemical correlations. Virchows Arch B Cell Pathol. 1976 Apr 29;20(3):185–196. doi: 10.1007/BF02890338. [DOI] [PubMed] [Google Scholar]
  20. Porush J. G., Grishman E., Alter A. A., Mandelbaum H., Churg J. Paraproteinemia and cryoglobulinemia associated with atypical glomerulonephritis and the nephrotic syndrome. Am J Med. 1969 Dec;47(6):957–964. doi: 10.1016/0002-9343(69)90208-3. [DOI] [PubMed] [Google Scholar]
  21. Stastny P., Ziff M. Cold-insoluble complexes and complement levels in systemic lupus erythematosus. N Engl J Med. 1969 Jun 19;280(25):1376–1381. doi: 10.1056/NEJM196906192802503. [DOI] [PubMed] [Google Scholar]
  22. Stekhoven J. H., van Haelst U. J. Unusual findings in the human renal glomerulus in multiple myeloma. A light- and electron-microscopic study. Virchows Arch B Cell Pathol. 1971;9(4):311–321. doi: 10.1007/BF02894054. [DOI] [PubMed] [Google Scholar]
  23. Trump B. F., Kim K. M., Iseri O. A. Cellular pathophysiology of hepatitis. Am J Clin Pathol. 1976 May;65(5 Suppl):828–847. [PubMed] [Google Scholar]
  24. Törnroth T., Skrifvars B. Ultrastructural changes in acute nonstreptococcal glomerulonephritis associated with mixed cryoglobulinemia. Exp Mol Pathol. 1973 Oct;19(2):160–167. doi: 10.1016/0014-4800(73)90075-0. [DOI] [PubMed] [Google Scholar]
  25. Urizar R. E., Michael A., Sisson S., Vernier R. L. Anaphylactoid purpura. II. Immunofluorescent and electron microscopic studies of the glomerular lesions. Lab Invest. 1968 Oct;19(4):437–450. [PubMed] [Google Scholar]
  26. Verroust P., Mery J. P., Morel-Maroger L., Clauvel J. P., Richet G., Bouteiller A. M., Fumagalli N. Glomerular lesions in monoclonal gammopathies and mixed essential cryoglobulinemias IgG-IgM. Adv Nephrol Necker Hosp. 1971;1:161–194. [PubMed] [Google Scholar]
  27. Yamada G., Tobe K., Kobayashi T., Ohta Y., Kosaka K. Letter: Virus-like particles in HBsAg-positive-chronic aggressive hepatitis and liver cirrhosis. Gastroenterology. 1976 Jan;70(1):149–149. [PubMed] [Google Scholar]

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