IS THERE AN IgM NEPHROPATHY?

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Abstract
Recent reports have suggested that there is a specific form of mesangial proliferative glomerulonephritis (GN) characterised by a diffuse and generalised mesangial deposition of IgM. The study included 149 consecutive patients with primary GN, who had adequate renal tissue for detailed light and immunofluorescent microscopy. Forty of these 149 patients had glomerular deposition of IgM. Of those 40, 20 had small and isolated focal deposits of IgM in sclerotic areas, but other immunoglobulins were predominant. The remaining 20 patients had IgM as the sole (16) or predominant (4) immunoglobulin deposited. Only one of these, however, fulfilled the published criteria of a mesangial proliferative GN with a diffuse and generalised mesangial deposition of IgM. The frequency of this entity in published series varies considerably, and there is a suspicion that in some studies patients with focal and segmental sclerosis and hyalinosis may have been included. More prospective studies are necessary to confirm whether there is a separate entity of IgM nephropathy.

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