Light Chain–Only Immunotactoid Glomerulopathy: A Case Report

Lihong Bu, Vincent Javaugue, Sophie Chauvet, Jerold Napier, Surendra Dasari, Jason D. Theis, Julie A. Vrana, Ellen D. McPhail, Samih H. Nasr

Research output: Contribution to journalArticlepeer-review


The monotypic variant of immunotactoid glomerulopathy (ITG), strongly associated with low-grade lymphoproliferative disorders, is characterized histologically by glomerulonephritis and microtubular deposits of monoclonal immunoglobulin G (IgG). We report a patient with high-risk κ light chain multiple myeloma who presented with acute kidney injury, hematuria, proteinuria, and hypocomplementemia. Kidney biopsy revealed immunotactoid glomerulopathy concomitant with κ light chain myeloma cast nephropathy. The glomerular microtubular deposits stained for κ light chain and C3 only. Proteomic analysis of glomeruli and atypical casts detected κ light chain constant domain and a single VL variability subgroup (IGKV3) in both glomeruli and casts (without γ, α, or μ heavy chain or λ light chain). C3, C5, C6, C7, and C9 were detected in glomeruli. No autoantibodies against alternative pathway of complement proteins were detected. Despite clone-directed chemotherapy, the patient remained on dialysis treatment. For this light chain–only variant of immunotactoid glomerulopathy, pathogenesis potentially involves activation of the alternative pathway of complement by a nephrotoxic κ light chain.

Original languageEnglish (US)
Pages (from-to)611-615
Number of pages5
JournalAmerican Journal of Kidney Diseases
Issue number5
StatePublished - May 2023


  • Alternative pathway of complement
  • Case report
  • Cast nephropathy
  • Dialysis
  • Immunoglobulin deposits
  • Immunotactoid glomerulopathy (ITG)
  • Kappa light chain
  • Monoclonal light chain
  • Proliferative glomerulonephritis
  • Renal failure

ASJC Scopus subject areas

  • Nephrology


Dive into the research topics of 'Light Chain–Only Immunotactoid Glomerulopathy: A Case Report'. Together they form a unique fingerprint.

Cite this