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ALL / Nephrology
Membranoproliferative glomerulonephritis
Membranoproliferative glomerulonephritis
Overview- also known as mesangiocapillary glomerulonephritis
- may present as nephrotic syndrome, haematuria or proteinuria
- poor prognosis
Type 1
- accounts for 90% of cases
- cause: cryoglobulinaemia, hepatitis C
- renal biopsy
- electron microscopy: subendothelial and mesangium immune deposits of electron-dense material resulting in a 'tram-track' appearance
Type 2 - 'dense deposit disease'
- causes: partial lipodystrophy (patients classically have a loss of subcutaneous tissue from their face), factor H deficiency
- caused by persistent activation of the alternative complement pathway
- low circulating levels of C3
- C3b nephritic factor is found in 70%
- an antibody to alternative-pathway C3 convertase (C3bBb)
- stabilizes C3 convertase
- renal biopsy
- electron microscopy: intramembranous immune complex deposits with 'dense deposits'
Type 3
- causes: hepatitis B and C
Management
- steroids may be effective
+PassMedicine Notes
Overview
- also known as mesangiocapillary glomerulonephritis
- may present as nephrotic syndrome, haematuria or proteinuria
- poor prognosis
- accounts for 90% of cases
- cause: cryoglobulinaemia, hepatitis C
- renal biopsy
- electron microscopy: subendothelial and mesangium immune deposits of electron-dense material resulting in a 'tram-track' appearance
- causes: partial lipodystrophy (patients classically have a loss of subcutaneous tissue from their face), factor H deficiency
- caused by persistent activation of the alternative complement pathway
- low circulating levels of C3
- C3b nephritic factor is found in 70%
- an antibody to alternative-pathway C3 convertase (C3bBb)
- stabilizes C3 convertase
- renal biopsy
- electron microscopy: intramembranous immune complex deposits with 'dense deposits'
- causes: hepatitis B and C
- steroids may be effective
