Filgrastim–induced crescentic transformation of recurrent IgG2λ GN

Ibrahim Batal, Glen S. Markowitz, Waichi Wong, Rupali Avasare, Markus Y. Mapara, Gerald B. Appel, Vivette D. D’Agati

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Proliferative GN with monoclonal IgG deposits is an increasingly recognized form of GN, but its relation to hematologic malignancy remains poorly understood. Filgrastim, an analog for granulocyte colony–stimulating factor produced by recombinant DNA technology, is frequently used to stimulate bone marrow release of hematopoietic progenitor cells in preparation for stem cell transplant. We report an exceptional case of proliferative GN with monoclonal IgG2γ deposits in a young man whose disease progressed slowly to CKD, which was followed by a preemptive kidney transplant. The patient developed recurrent GN in the allograft and clinically detectable plasma cell neoplasm 9 years after the first renal manifestations. Contemporaneous with filgrastim administration for stem cell mobilization, the patient’s slowly progressive GN underwent severe crescentic transformation, leading to rapidly progressive and irreversible allograft failure. This report explores the spectrum of GN with monoclonal IgG deposits and the pathophysiologic role of granulocyte colony–stimulating factor in exacerbation of preexisting GN.

Original languageEnglish (US)
Pages (from-to)1911-1915
Number of pages5
JournalJournal of the American Society of Nephrology
Volume27
Issue number7
DOIs
StatePublished - 2016
Externally publishedYes

ASJC Scopus subject areas

  • Nephrology

Fingerprint

Dive into the research topics of 'Filgrastim–induced crescentic transformation of recurrent IgG2λ GN'. Together they form a unique fingerprint.

Cite this