Statistics

 array:21 [
  "pii" => "X2013251412002123"
  "issn" => "20132514"
  "doi" => "10.3265/Nefrologia.pre2012.Jul.11488"
  "estado" => "S300"
  "fechaPublicacion" => "2012-11-01"
  "documento" => "article"
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Nefrologia (English Version). 2012;32:846-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 4803
    "formatos" => array:3 [
      "EPUB" => 301
      "HTML" => 3986
      "PDF" => 516
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:17 [
      "pii" => "X0211699512002126"
      "issn" => "02116995"
      "doi" => "10.3265/Nefrologia.pre2012.Jul.11488"
      "estado" => "S300"
      "fechaPublicacion" => "2012-11-01"
      "documento" => "article"
      "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
      "subdocumento" => "fla"
      "cita" => "Nefrologia. 2012;32:846-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 8887
        "formatos" => array:3 [
          "EPUB" => 296
          "HTML" => 7921
          "PDF" => 670
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "titulo" => "Glomerulonefritis membranoproliferativa con depósito de IgG monoclonal en el mieloma múltiple"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "846"
            "paginaFinal" => "848"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Proliferative glomerulonephritis with monoclonal IgG deposits in multiple myeloma"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:8 [
            "identificador" => "fig1"
            "etiqueta" => "Fig. 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "copyright" => "Elsevier España"
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "11488_19759_30050_es_11488_f1.jpg"
                "Alto" => 338
                "Ancho" => 450
                "Tamanyo" => 191098
              ]
            ]
            "descripcion" => array:1 [
              "es" => "Microscopía óptica. HE x10. Glomérulo que muestra proliferación mesangial, endocapilar y engrosamiento de paredes capilares"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M. Dolores Redondo-Pachón, Ricardo Enríquez, Ana E. Sirvent, Encarna Andrada, Raimundo García-del Moral, Isabel Millán, Francisco Amorós"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "M. Dolores"
                "apellidos" => "Redondo-Pachón"
              ]
              1 => array:2 [
                "nombre" => "Ricardo"
                "apellidos" => "Enríquez"
              ]
              2 => array:2 [
                "nombre" => "Ana E."
                "apellidos" => "Sirvent"
              ]
              3 => array:2 [
                "nombre" => "Encarna"
                "apellidos" => "Andrada"
              ]
              4 => array:2 [
                "nombre" => "Raimundo"
                "apellidos" => "García-del Moral"
              ]
              5 => array:2 [
                "nombre" => "Isabel"
                "apellidos" => "Millán"
              ]
              6 => array:2 [
                "nombre" => "Francisco"
                "apellidos" => "Amorós"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "X2013251412002123"
          "doi" => "10.3265/Nefrologia.pre2012.Jul.11488"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412002123?idApp=UINPBA000064"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699512002126?idApp=UINPBA000064"
      "url" => "/02116995/0000003200000006/v0_201502091338/X0211699512002126/v0_201502091340/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "X2013251412002115"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2012.Jul.11556"
    "estado" => "S300"
    "fechaPublicacion" => "2012-11-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia (English Version). 2012;32:848-50"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 6653
      "formatos" => array:3 [
        "EPUB" => 284
        "HTML" => 5749
        "PDF" => 620
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Amyloidosis AL with severe renal and cardiac involvement: a very rare association of terrible prognosis, two case reports"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "848"
          "paginaFinal" => "850"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Debut de amiloidosis AL con afectación grave cardíaca y renal: una asociación poco frecuente de infausto pronóstico. A raíz de 2 casos"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig1"
          "etiqueta" => "Tab.  1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "copyright" => "Elsevier España"
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "11556_108_39794_en_t110.jpg"
              "Alto" => 1979
              "Ancho" => 1442
              "Tamanyo" => 511114
            ]
          ]
          "descripcion" => array:1 [
            "en" => "Laboratory parameters of the two cases upon hospitalisation"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Maria Núñez-Torras, Nàdia Martín-Alemany, Martí Vallès-Prats, Xavier Albert-Bertran"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Maria"
              "apellidos" => "Núñez-Torras"
            ]
            1 => array:2 [
              "nombre" => "Nàdia"
              "apellidos" => "Martín-Alemany"
            ]
            2 => array:2 [
              "nombre" => "Martí"
              "apellidos" => "Vallès-Prats"
            ]
            3 => array:2 [
              "nombre" => "Xavier"
              "apellidos" => "Albert-Bertran"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699512002118"
        "doi" => "10.3265/Nefrologia.pre2012.Jul.11556"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699512002118?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412002115?idApp=UINPBA000064"
    "url" => "/20132514/0000003200000006/v0_201502091602/X2013251412002115/v0_201502091603/en/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "X2013251412002131"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2012.Jun.11496"
    "estado" => "S300"
    "fechaPublicacion" => "2012-11-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia (English Version). 2012;32:845-6"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3554
      "formatos" => array:3 [
        "EPUB" => 277
        "HTML" => 2696
        "PDF" => 581
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Abandonment of peritoneal dialysis due to peritonitis: Have the responsible agents changed? Our experience"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "845"
          "paginaFinal" => "846"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Abandono de diálisis peritoneal por peritonitis: ¿han cambiado los agentes responsables? Nuestra experiencia"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig1"
          "etiqueta" => "Tab.  1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "copyright" => "Elsevier España"
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "11496_108_39778_en_t18.jpg"
              "Alto" => 545
              "Ancho" => 1426
              "Tamanyo" => 137848
            ]
          ]
          "descripcion" => array:1 [
            "en" => "Aetiology of cases of peritonitis that caused abandonment of peritoneal dialysis"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Raquel Blanco-García, Walfred Nájera-de la Garza, Mercedes Moreiras-Plaza, Juan J. Bravo-López, Gloria Rodríguez-Goyanes, Cynthia Cossio-Anibar, Laura Beato-Coo"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "Raquel"
              "apellidos" => "Blanco-García"
            ]
            1 => array:2 [
              "nombre" => "Walfred"
              "apellidos" => "Nájera-de la Garza"
            ]
            2 => array:2 [
              "nombre" => "Mercedes"
              "apellidos" => "Moreiras-Plaza"
            ]
            3 => array:2 [
              "nombre" => "Juan J."
              "apellidos" => "Bravo-López"
            ]
            4 => array:2 [
              "nombre" => "Gloria"
              "apellidos" => "Rodríguez-Goyanes"
            ]
            5 => array:2 [
              "nombre" => "Cynthia"
              "apellidos" => "Cossio-Anibar"
            ]
            6 => array:2 [
              "nombre" => "Laura"
              "apellidos" => "Beato-Coo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699512002134"
        "doi" => "10.3265/Nefrologia.pre2012.Jun.11496"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699512002134?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412002131?idApp=UINPBA000064"
    "url" => "/20132514/0000003200000006/v0_201502091602/X2013251412002131/v0_201502091603/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "titulo" => "Proliferative glomerulonephritis with monoclonal IgG deposits in multiple myeloma"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "846"
        "paginaFinal" => "848"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "M. Dolores Redondo-Pachón, Ricardo Enríquez, Ana E. Sirvent, Encarna Andrada, Raimundo García-del Moral, Isabel Millán, Francisco Amorós"
        "autores" => array:7 [
          0 => array:4 [
            "nombre" => "M. Dolores"
            "apellidos" => "Redondo-Pachón"
            "email" => array:1 [
              0 => "dolypa@hotmail.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Ricardo"
            "apellidos" => "Enr&#237;quez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Ana E&#46;"
            "apellidos" => "Sirvent"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Encarna"
            "apellidos" => "Andrada"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Raimundo"
            "apellidos" => "Garc&#237;a-del Moral"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "affc"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Isabel"
            "apellidos" => "Mill&#225;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Francisco"
            "apellidos" => "Amor&#243;s"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Servicio de Nefrología, Hospital general de Elche,  Alicante,  "
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "affa"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Anatomía Patológica, Hospital general de Elche,  Alicante,  "
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "affb"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario San Cecilio, Granada,   "
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "affc"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Glomerulonefritis membranoproliferativa con dep&#243;sito de IgG monoclonal en el mieloma m&#250;ltiple"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Fig. 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "11488_108_39789_en_f19.jpg"
            "Alto" => 488
            "Ancho" => 661
            "Tamanyo" => 134403
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Light microscope image&#46; HE x10&#46; Glomerulus with mesangial and endocapillary proliferation and thickening of capillary walls"
        ]
      ]
    ]
    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">To the Editor&#58;</span></p><p class="elsevierStylePara">Glomerular deposits of monoclonal immunoglobulins can arise as a condition secondary to a number of different entities&#44; including AL amyloidosis&#44; Randall type monoclonal immunoglobulin deposition disease &#40;MIDD&#41;&#44; type 1 cryoglobulinaemia&#44; immunotactoid&#47;fibrillar glomerulonephritis&#44; and the most recently described&#44; non-Randall type proliferative glomerulonephritis with monoclonal IgG glomerular deposits &#40;MIgG PGN&#41;&#46;<span class="elsevierStyleSup">1</span></p><p class="elsevierStylePara">Here we described the case of a patient with nephrotic syndrome and renal failure&#44; whose examination led to the diagnosis of multiple myeloma and MIgG PGN&#46;</p><p class="elsevierStylePara">Our patient was a 76-year old male who sought treatment due to renal failure and oedema&#44; with two months evolution&#46; The patient&#8217;s medical history only mentioned arterial hypertension&#46; A physical examination revealed pitting oedema in the legs up to the knees and no other relevant findings&#46; Complementary tests revealed&#58; haemoglobin&#58; 7&#46;7g&#47;dl&#59; creatinine&#58; 3&#46;4mg&#47;dl&#59; albumin&#58; 2&#46;1g&#47;dl&#59; total cholesterol&#58; 232mg&#47;dl&#59; IgG&#58; 304mg&#47;dl&#59; IgA&#58; 958mg&#47;dl&#59; IgM&#58; 40mg&#47;dl&#59; C3&#58; 79mg&#47;dl&#59; all other tests&#44; including C4&#44; rheumatoid factors&#44; antinuclear antibodies&#44; anti-DNA antibodies&#44; anti-neutrophil cytoplasmic antibodies&#44; anti-GBM&#44; and cryoglobulin results were all normal&#47;negative&#46; Serology tests for hepatitis B and C virus and human immunodeficiency virus were all negative&#46; Urine analysis&#58; proteinuria&#58; 11g&#47;24h&#59; urinary sediment&#58; 6-12 leukocytes per field&#44; 250 red blood cells per field&#44; and negative urine culture&#46; High resolution electrophoresis of urine and blood samples revealed a lambda IgA monoclonal component&#46; A bone marrow core sample revealed a hypercellular medulla with 13&#37; plasma cells of aberrant morphology&#44; compatible with the diagnosis of lambda IgA type multiple myeloma&#46; A chest x-ray&#44; abdominal ultrasound&#44; and computed axial tomography of the chest&#44; abdomen&#44; and pelvis all failed to produce relevant findings&#46;</p><p class="elsevierStylePara">A percutaneous renal biopsy &#40;23 glomeruli&#41; revealed mesangial and endocapillary proliferation with splitting&#47;thickening of the capillary walls &#40;Figure 1&#41;&#59; immunofluorescence revealed evidence of IgG&#44; C3&#44; C1q&#44; and lambda chain deposits in the glomeruli studied&#59; kappa chain stain test was negative&#59; no relevant deposits were observed in the tubules&#59; and Congo red stain was negative&#46; In the electron microscope analysis&#44; we observed fused foot processes&#44; mesangial interpositioning&#44; and subendothelial electrodense deposits&#59; there were no fibrils or microtubules&#46; These findings were compatible with the diagnosis of MIgG PGN&#46; We treated the patient with dexamethasone and bortezomib&#46; Three months later&#44; the patient sought treatment for acute enteritis and bacteraemia from <span class="elsevierStyleItalic">Escherichia coli</span>&#44; with deteriorated renal function that did not recover&#44; and the patient was started on haemodialysis&#46;</p><p class="elsevierStylePara">Nasr et al&#46;<span class="elsevierStyleSup">2</span> considered MIgG PGN as an entity defined by glomerular deposition of monoclonal IgG &#40;predominantly IgG3&#41;&#44; along with a light chain isotype&#44; absence of tubular deposits&#44; and electron microscope findings similar to those from cases of immunocomplex glomerulonephritis&#59; in addition&#44; these authors defined this condition as involving an absence of clinical and laboratory evidence of cryoglobulinaemia&#46; In a 37-patient study&#44; the most common histological forms were membranoproliferative GN and endocapillary proliferative GN&#59; nephrotic syndrome and renal failure were the most common forms of presentation&#46; In 30&#37; of cases&#44; there was also a monoclonal component encountered in serum samples&#44; but only one case of myeloma&#59; 10 patients had hypocomplementaemia&#46; In another study&#44;<span class="elsevierStyleSup">3</span> membranous GN was the predominant form&#44; and other haemopathies were encountered in addition to myeloma&#44; such as chronic lymphatic leukaemia and non-Hodgkin&#8217;s lymphoma&#46; Sethi et al&#46;<span class="elsevierStyleSup">4</span> also described patients with membranoproliferative GN&#44; associated with monoclonal gammapathy&#44; with glomerular deposits of monoclonal IgG and IgM&#46;</p><p class="elsevierStylePara">The differential diagnosis of MIgG PGN must take into account the aforementioned diseases&#44; and especially Randall type MIDD &#40;heavy&#47;light chain deposition type&#41;&#46;<span class="elsevierStyleSup">5</span> In this disease&#44; the most typical glomerular involvement is nodular glomerulosclerosis&#44; although membranoproliferative GN can also be observed&#44; tubular deposits are practically a constant&#44; and the electron microscope findings would be different&#46; However&#44; some authors include MIgG PGN within the spectrum of MIDD&#46;<span class="elsevierStyleSup">6</span> For now&#44; it is still not clear whether considering MIgG PGN as a distinct entity may produce therapeutic repercussions&#46;</p><p class="elsevierStylePara">In our patient&#44; the immunofluorescence result of a unique light chain isotype suggests a type of nephropathy from monoclonal immunoglobulin deposition&#59; the absence of tubular deposits and electron microscope findings were in favour of the diagnosis of MIgG PGN&#46; There was a discrepancy between the monoclonal peak encountered in serum samples &#40;lambda IgA&#41; and in deposits &#40;lambda IgG&#41;&#44; which has already been described in another case of MIgG PGN&#44;<span class="elsevierStyleSup">7</span> and which would be due to a rapid tissue precipitation of the IgG component&#44; or concentrations in serum samples that are below the detectable threshold&#46;</p><p class="elsevierStylePara">To conclude&#44; MIgG PGN must be considered as a possible diagnosis&#44; among others&#44; in patients with glomerular deposits of monoclonal immunoglobulin&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflicts of interest</span></p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">The authors state that they have no potential conflicts of interest related to the content of this article&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><a href="grande&#47;11488&#95;108&#95;39789&#95;en&#95;f19&#46;jpg" class="elsevierStyleCrossRefs"><img src="11488_108_39789_en_f19.jpg" alt="Light microscope image&#46; HE x10&#46; Glomerulus with mesangial and endocapillary proliferation and thickening of capillary walls"></img></a></p><p class="elsevierStylePara">Figure 1&#46; Light microscope image&#46; HE x10&#46; Glomerulus with mesangial and endocapillary proliferation and thickening of capillary walls</p>"
    "pdfFichero" => "P1-E544-S3783-A11488-EN.pdf"
    "tienePdf" => true
    "multimedia" => array:1 [
      0 => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Fig. 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "11488_108_39789_en_f19.jpg"
            "Alto" => 488
            "Ancho" => 661
            "Tamanyo" => 134403
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Light microscope image&#46; HE x10&#46; Glomerulus with mesangial and endocapillary proliferation and thickening of capillary walls"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliography"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:7 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Nasr SH, Markowitz GS, Stokes MB, Seshan SV, Valderrama E, Appel GB,\u{A0}et al. Proliferative glomerulonephritis with monoclonal IgG deposits: a distinct entity mimicking immune-complex glomerulonephritis. Kidney Int 2004;65:85-96. <a href="http://www.ncbi.nlm.nih.gov/pubmed/14675039" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Nasr SH, Satoskar A, Markowitz GS,\u{A0}\u{A0}Valeri AM, Appel GB, Stokes MB, et al. Proliferative glomerulonephritis with monoclonal IgG deposits. J Am Soc Nephrol 2009;20:2055-64. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19470674" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Guiard E, Karras A, Plaisier E, Duong Van Huyen JP, Fakhouri F, Rougier JP, et al. Patterns of noncryoglobulinemic glomerulonephritis with monoclonal Ig deposits: correlation with IgG subclass and response to rituximab. Clin J Am Soc Nephrol 2011;6:1609-16. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21700823" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "4.\u{A0}Sethi S, Zand L, Leung N, Smith RJ, Jevremonic D, Herrmann SS, et al. Membranoproliferative glomerulonephritis secondary to monoclonal gammopathy. Clin J Am Soc Nephrol 2010;5:770-82. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20185597" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Masai R, Wakui H, Komatsuda A, Togashi M, Maki N, Ohtani H, et al. Characteristics of proliferative glomerulonephritis with monoclonal IgG deposits associated with membranoproliferative features. Clin Nephrol 2009;72:46-54. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19640387" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Chang A, Peutz-Kootstra CJ, Richardson CA, Alpers CE. Expanding the pathologic spectrum of light chain deposition disease: a rare variant with clinical follow-up of 7 years. Mod Pathol 2005;18:998-1004. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15696120" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Evans DJ, Macanovic M, Dunn MJ, Pusey CD. Membranous glomerulonephritis associated with follicular B-cell lymphoma and subepithelial deposition of IgG1-k paraprotein. Nephron Clin Pract 2003;93:c112-c118. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12660420" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000003200000006/v0_201502091602/X2013251412002123/v0_201502091603/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "35437"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor - Brief Case Reports"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003200000006/v0_201502091602/X2013251412002123/v0_201502091603/en/P1-E544-S3783-A11488-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412002123?idApp=UINPBA000064"
]