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Case Report
©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2024; 12(17): 3200-3205
Published online Jun 16, 2024. doi: 10.12998/wjcc.v12.i17.3200
Congophilic fibrils in the glomeruli with polyclonal immunoglobulin gamma staining - another cause for diagnostic overlap: A case report
Anjali A Satoskar, Mirza Hamirani, April Chiu, Irmeen Siddiqui, Lucas Bushrow, Maria Bernadette Che-Ying Chow
Maria Bernadette Che-Ying Chow, Lucas Bushrow, Irmeen Siddiqui, Anjali A Satoskar, Department of Pathology, The Ohio State University Medical Center, Columbus, OH 43210, United States
Maria Bernadette Che-Ying Chow, Department of Pathology, North District Hospital, Sheung Shui, Hong Kong, China
April Chiu, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, United States
Mirza Hamirani, Department of Internal Medicine, S. Joseph's Hospital, Parkersburg, WV 26101, United States
Author contributions: Chow MBCY drafted and revised the manuscript; Bushrow L helped draft the manuscript; Siddiqui I helped with serum immunofixation results; Chiu A provided mass spectrometry result and Figure 2; Hamirani H provided clinical follow-up and obtained patient consent; Satoskar AA conceptualized and the idea and implemented the collaborative effort, drafted and revised the manuscript, and provided immunofluorescence images.
Informed consent statement: Study participant provided informed written consent prior to study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Anjali A Satoskar, MD, Professor, Department of Pathology, The Ohio State University Medical Center, B073 Graves Hall 333 W 10th Ave, Columbus, OH 43210, United States. anjali.satoskar@osumc.edu
Received: February 6, 2024
Revised: March 15, 2024
Accepted: April 23, 2024
Published online: June 16, 2024
Processing time: 118 Days and 16.2 Hours
Core Tip

Core Tip: Amyloidosis and fibrillary glomerulonephritis are the two most commonly encountered glomerulopathies with fibrillary deposits. Accurate diagnosis and differentiation between these two entities are important for patient management. Furthermore, accurate subtyping is also required for amyloidosis cases to further guide treatment. This case report highlights an uncommon diagnostic pitfall that a nephropathologist may encounter while distinguishing light and heavy chain amyloid from fibrillary glomerulopathy. The possible underlying mechanisms are discussed, and we reiterate the importance of a clinical-pathological correlation and the use of multiple available diagnostic modalities if needed, particularly for these overlapping diagnostic entities.