Monoclonal immunoglobulin deposition disease in a renal allograft: probable recurrent disease in a patient without myeloma

A case in which monoclonal IgG-kappa deposition in the glomeruli of a renal allograft apparently resulted in graft failure is described. Review of biopsy material obtained from the patient's native kidney biopsy indicates a high probability that this glomerulopathy represents recurrent disease in the allograft. The reported transplantation experience with this entity (monoclonal immunoglobulin deposition disease; light-chain nephropathy) is limited; this case indicates the potential for disease recurrence even in the absence of a systemic lymphoplasmacytic disorder.