Glomerulonefritis fibrilar en paciente peruano: remisión funcional parcial tras inmunosupresión en hospital regional

ABSTRACT Introduction: Fibrillary glomerulonephritis (FGN) is a rare glomerular disease characterized by non-Congo red-reactive fibrillar deposits, diagnosed definitively by electron microscopy. Case presentation: We report a 59-year-old Peruvian male presenting with progressive renal failure and nephrotic syndrome requiring hemodialysis. Renal biopsy and electron microscopy revealed fibrillary deposits in glomeruli, mesangium, and tubules. Hepatitis C virus (HCV) serology was initially positive but active infection was excluded by negative viral load. Immunosuppressive therapy with prednisone and mycophenolate mofetil was initiated. Clinical outcome: After six months, partial renal recovery and remission of proteinuria allowed withdrawal from dialysis. At 24 months, renal function remains stable with no significant relapse. Conclusion: FGN may show favorable response to immunosuppression in selected cases without monoclonal gammopathy or active infection, highlighting the importance of early diagnosis and sustained follow-up.