Membranoproliferative glomerulonephritis
| Membranoproliferative glomerulonephritis Classification and external resources |
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| ICD-10 | N00-N08 with .2 suffix |
|---|---|
| ICD-9 | 581.2, 582.2, 583.2 |
| MeSH | D015432 |
Membranoproliferative glomerulonephritis or MPGN is a type of glomerulonephritis caused by deposits in the kidney glomerular mesangium and basement membrane (GBM), activating complement and damaging the glomeruli. The GBM is rebuilt on top of the deposits, causing a "tram-tracking" appearance under the microscope. MPGN accounts for approximately 4% of primary renal causes of nephrotic syndrome in children and 7% in adults.[1]
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Type
There are three types of MPGN.
- Type I the most common by far, is caused by immune complexes depositing in the kidney.
- Type II (dense deposit disease) is similar to type I, except the material deposited is not immune complexes and is not yet known. Spontaneous remissions of MPGN II are rare, approximately half of those affected with MPGN II will progress to End Stage Renal Disease within 10 years.[2]
In many cases, people with MPGN II can develop drusen which is caused by same deposits within the Bruch's membrane beneath the retinal pigment epithelium (RPE) layer of the eye. Over time vision can deteriorate and subretinal neovascular membranes, macular detachment, and central serous retinopathy develop.[3]
Recent research suggests that dense deposit disease may not be a membranoproliferative glomerulonephritis subtype.[4]
- Type III is very rare, it is characterized by a mixture of subepithelial deposits and the typical pathological findings of Type I disease.
See also
- Membranous glomerulonephritis, a condition in where only the basement membrane is thickened.
References
- ^ Habib R, Gubler MC, Loirat C, Mäiz HB, Levy M (1975). "Dense deposit disease: a variant of membranoproliferative glomerulonephritis". Kidney Int. 7 (4): 204–15. PMID 1095806.
- ^ Swainson CP, Robson JS, Thomson D, MacDonald MK (1983). "Mesangiocapillary glomerulonephritis: a long-term study of 40 cases". J. Pathol. 141 (4): 449–68. doi:10.1002/path.1711410404. PMID 6363655.
- ^ Colville D, Guymer R, Sinclair RA, Savige J (2003). "Visual impairment caused by retinal abnormalities in mesangiocapillary (membranoproliferative) glomerulonephritis type II ("dense deposit disease")". Am. J. Kidney Dis. 42 (2): E2–5. PMID 12900843, http://linkinghub.elsevier.com/retrieve/pii/S0272638603006656.
- ^ Patrick D Walker, Franco Ferrario, Kensuke Joh, Stephen M Bonsib (2007), "Dense deposit disease is not a membranoproliferative glomerulonephritis", Modern Pathology. 20: 605–616, doi:10.1038/modpathol.3800773, http://www.nature.com/modpathol/journal/v20/n6/abs/3800773a.html
External links
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