Kidney Disease with IgM-Positive Plasma Cells

What is it about?

Kidney disease with IgG-positive plasma cells is a common. It had been thought that plasma cells secrete IgG, but not IgM. Routine immunofluorescence of frozen sections is considered the gold standard. However, the immunoenzyme method with paraffin-embedded sections is superior for detecting IgM- or IgG-positive cells within kidney, thus histologic variants may often go undetected. We identified 13 patients with kidney disease with IgM-positive plasma cells by using the immunoenzyme method.

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Why is it important?

The clinical findings included urinary acidification impairment (100%), extensive tubular dysfunction (92%), and anti-mitochondrial antibodies (82%). The microscopic findings were tubulointerstitial nephritis. Levels of proton pumps and anion exchanger, which modulate urinary acidification, were markedly decreased. We newly propose to designate this group, which have a common clinical and microscopic form, as IgM-positive plasma cell-tubulointerstitial nephritis (IgMPC-TIN).

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