Membroproliferative Glomerulonephropathy
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Introduction
Membroproliferative glomerulonephropathy is common in children and young adults, females moreso than males.
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.
Causes and Risk Factors
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.
Pathophysiology
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.
Signs and Symptoms
- history
- physical exam
History
Physical Exam
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Membroproliferative GN can present with asymptomatic hematuria or combined nephritic/nephrotic syndrome.
Diagnostic Imaging
Differential Diagnosis
Treatments
Treatment includes dialysis and renal transplantation, but recurrence can also follow transplant, particularly in type II disease.
Consequences and Course
Prognosis can be poor, with frequent progression to end-stage renal failure.
Resources and References
Topic Development
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