Monoclonal Gammopathy, Glomerulonephritis, and the Nephrotic Syndrome

Abstract

The occurence of the nephrotic syndrome is glomerulonephritis is well established; multiple myeloma, while listed in the differential diagnosis of the nephrotic syndrome, appears to be an unusual and infrequent cause. During the investigation of a patient with rapidly progressive renal failure, microscopic examination of a percutaneous renal biopsy specimen provided a diagnosis of proliferative glomerulonephritis. An IgG paraprotein was demonstrable in the serum and plasma cell proliferation was noted in a bone-marrow aspirate. The presence of the nephrotic syndrome in this same patient was also substantiated. To the best of our knowledge, this patient is the first to evidence the peculiar combination of proliferative glomerulonephritis, the nephrotic syndrome, and a monoclonal gammopathy. Patient Summary A 49-year-old white male coal miner was admitted to the Medical Service of the West Virginia University Medical Center on April 28, 1967, for evaluation of anemia. He had been seen previously at the medical