Immunotactoid glomerulopathy Review


Authors: Abramson, M.; Shaikh, A.
Review Title: Immunotactoid glomerulopathy
Abstract: Immunotactoid glomerulopathy (ITG) is a rare glomerular disease that typically presents with proteinuria, hematuria, and kidney dysfunction. A kidney biopsy is essential to establish the diagnosis of ITG. ITG is characterized by glomerular electron-dense immunoglobulin deposits with hollow-cored microtubules. ITG is classified as either monoclonal or polyclonal based on immunofluorescence staining of the immunoglobulin deposits. Monoclonal ITG is associated with an underlying hematologic disorder in two-thirds of the cases, lymphoma and plasma cell dyscrasias being the most common. Polyclonal ITG is associated with autoimmune diseases but can be seen with hematologic disorders and chronic infections. Due to the preponderance of hematologic disorders in both monoclonal and polyclonal ITG, a thorough hematologic workup must be performed in all cases of ITG. In monoclonal ITG with a detectable clone, clone-directed therapy is administered to achieve hematologic remission, as the renal response is highly dependent on the hematologic response. In clone-negative monoclonal ITG, anti-B cell therapy is often used as a first-line therapy. Management of polyclonal ITG without an underlying hematologic disorder is poorly defined. Compared to monoclonal ITG, patients with polyclonal ITG have a higher risk of progression to end-stage kidney disease. Recurrence of ITG following kidney transplantation is common and is often associated with hematologic relapse. © 2024 National Kidney Foundation, Inc.
Keywords: immunohistochemistry; adult; review; immunofluorescence; retrospective study; hematuria; monoclonal antibody; drug combination; diagnosis; remission; drug therapy; microtubule; kidney biopsy; proteinuria; therapy; kidney transplantation; plasma cell dyscrasia; first-line treatment; immunoglobulin deposition; end stage renal disease; glomerulus; human; glomerulopathy; special situation for pharmacovigilance; hematologic disorder; immunotactoid; b cell depletion therapy
Journal Title: Advances in Kidney Disease and Health
Volume: 31
Issue: 4
ISSN: 2949-8139
Publisher: Elsevier Inc.  
Date Published: 2024-07-01
Start Page: 326
End Page: 333
Language: English
DOI: 10.1053/j.akdh.2024.03.003
PROVIDER: scopus
PUBMED: 39084758
DOI/URL:
Notes: Source: Scopus
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  1. Aisha Shaikh
    8 Shaikh