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Membroproliferative glomerulonephropathy is common in children and young adults, females moreso than males.
a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.
Primary membranoproliferative GN can occur in two different patterns.
Type I is the more common, and is caused by subendothelial deposition by immune complexes. It can follow infection, tumours, drug reactions, genetic disorders, SLE, and complement deficiencies.
Type II is cause by activation of the alternative complement pathway following infection.
Global basement membrane thickening and mesangial proliferation are seen.
In type I disease, immune complex deposition leads to inflammation and capillary thickening.
In type II disease, C3 complement deposition also leads to thickened capillaries. It is associated with partial lipodystrophy.
Basement membrane is rebuilt on top of areas of damage.
Membroproliferative GN can present with asymptomatic hematuria or combined nephritic/nephrotic syndrome.
Treatment includes dialysis and renal transplantation, but recurrence can also follow transplant, particularly in type II disease.
Prognosis can be poor, with frequent progression to end-stage renal failure.
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