A 70-year-old man with diabetes mellitus was referred to the hospital for treatment of renal dysfunction. Renal biopsy revealed that the tubular basement membrane (TBM) showed extreme thickening histologically and selective polyclonal immunoglobulin G deposition on the thickened TBM. No immunoglobulin deposition was found in the glomeruli in an immunofluorescence study. In electron microscopy, a powdery type of electron-dense material was observed on the tubular epithelial side of the TBM. 

 

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