Heavy chain deposition disease: Recurrence in a renal transplant and report of IgG(2) subtype

Heavy chain deposition disease (HCDD) is a rare entity characterized by tis sue deposition of monoclonal heavy chains without light chains. Previous re ports of HCDD include gamma(1)-, gamma(3)-, gamma(4)-, and alpha-heavy chai n subtypes. Renal transplantation for HCDD has not been previously reported . We report a case of gamma(2)-HCDD in a 67-year-old patient who presented with proteinuria, hematuria, and renal insufficiency and progressed to end- stage renal failure after 6 months. The second case involves a 26-year-old woman who had a renal transplant for HCDD and recurrent gamma(1)-HCDD in th e transplant. Neither patient had myeloma. The complete spectrum of gamma-H CDD subtypes has now been reported. Further data are required to make concl usive statements about the true recurrence rate of HCDD in renal transplant s. (C) 2000 by the National Kidney Foundation, Inc.