Monoclonal Gammopathy of Renal Significance with Deposits of Peculiar Morphology and Injuries of Secondary Thrombotic Microangiopathy: A Case Report and Review of the Literature

Table 1

Laboratory findings on admission.

		Reference range/unit
WBC	3978	U/L
Hemoglobin (Hb)	11.3	12–16 g/dL
Platelet count (PLt)	168	10^3/μL
Reticulocyte count	2.77	2–4%
Haptoglobin	93	30–200 mg/dL
Lactate dehydrogenase (LDH)	385	135–214 IU/L
ADAMTS 13 activity	15	<10%
Coombs test	Negative	NA
Total bilirubin	0.3	0.1–1 mg/dL
Total protein (TP)	5.9	6.4–8.7 g/dL
Serum albumin (Alb)	2.6	3–5.5 g/dL
GOT	29	5–32 IU/L
GPT	21	5–33 IU/L
Urea	83	17–60 mg/dL
Creatinine	1.93	0.6–1.2 mg/dL
Na	141	135–145 mmol/L
K	4.2	3.5–5.5 mmol/L
Cl	101	95–110 mmol/L
CRP	2.51	0.1–0.5 mg/dL
HbsAg	Negative	NA
HCV-Ab	Negative	NA
HIV	Negative	NA
CH50	45	40–90 U/ml
CFH	250	225–760 μg/mL
Autoantibodies CFH	Negative	<18 AU/L
C3 nephritic factor (C3NF)	Negative	Ratio > 1.022
C3	60	90–180 mg/dL
C4	13.3	10–40 mg/dL
RF	Negative	<15 IU/ml
ANA, anti-ds-DNA, ANCA, and cryoglobulin	Negative	NA
Anti-GBM	Negative	<1 AI
Anti-PLA2R Ab (ELISA)	Negative	NA
IgG	1060	800–1600 mg/dL
IgA	100	70–400 mg/dL
IgM	127	90–180 mg/dL
Urine protein	4.9	<0.03 g/gCr
Urine red blood cells	25–35	/HPF
Protein excretion	>300	mg/dl
SPEP M-protein concentration	3.83	Negative g/L
SIF	IgG κ	NA
Urine immunofixation electrophoresis: IgG κ	43.1	NA mg/dL
FLC κ	26.6	0.33–1.54 mg/dL
FLC λ	28.6	0.57–2.63 mg/dL
FLC κ/λ	0.93	0.26–1.65

AI: activity index, AU: arbitrary units, NA: not applicable, CFH: complement factor H, ANA: antinuclear antibody, anti-ds-DNA: anti-double-stranded DNA antibody, ANCA: antineutrophil cytoplasmic autoantibody, anti-GBM: antiglomerular basement membrane, RF: rheumatoid factor, anti-PLA2R Ab: antiphospholipase A2 receptor antibody, ELISA: enzyme-linked immunosorbent assay, SPEP: serum protein electrophoresis, SIF: serum immunofixation, FLC: free light chain, and HPF: high-power field.