Glomerulonephritis - Membranous Glomerulonephritis

Question 1

Epidemiology of Membranous Glomerulonephritis (2).

Answer 1

1. Bimodal Peak in 20s and 60s.

2. Commonest type of glomerulonephritis.

Question 2

Aetiology of Membranous Glomerulonephritis (5).

Answer 2

1. 70% Idiopathic (Anti-Phospholipase A2 Antibodies).
2. Malignancy : Prostate, Lung, Lymphoma, Leukaemia.
3. Infections.
4. Drugs.
5. Autoimmune Disorders.

Question 3

Nephrotic or Nephritic Nature of Membranous Glomerulonephritis.

Answer 3

Nephrotic Syndrome.

Question 4

Investigations of Membranous Glomerulonephritis.

Answer 4

Electron Microscopy : ‘Spike and Dome’ Appearance - basement membrane is thickened with sub epithelial electron-dense deposits.

Question 5

Management of Membranous Glomerulonephritis (3).

Answer 5

1. All Patients : ACE Inhibitor or ARB (reduce proteinuria and good prognosis).
2. Severe/Progressive Disease : Immunosuppression with Corticosteroid + Cyclophosphamide.
3. High-Risk Patients : Anticoagulation.

Question 6

Good Prognostic Factors of Membranous Glomerulonephritis (3).

Answer 6

1. Female Sex.
2. Young Age at Presentation.
3. Asymptomatic Proteinuria of Modest Degree.