Membranoproliferative Glomerulonephritis

Question 1

Membranoproliferative Glomerulonephritis another name ….?

Answer 1

Mesangiocapillary glomerulonephritis,

Question 2

The most common age group for Membranoproliferative glomerulonephritis (MPGN) …?

Answer 2

Most commonly occurs in older children or young adults

Question 3

Two subtypes have been defined on histologic criteria ……. ?

Answer 3

Type I MPGN is most common

type II MPGN, also called dense deposit disease

Question 4

Difference between type 1 and type 2 MPGN …?

Answer 4

type II MPGN, also called dense deposit disease, which has similar light microscopic findings as type I MPGN. Differentiation from type I disease is by immunofluorescence and electron microscopy. In type II disease, C3 immunofluorescence typically is prominent, without concomitant immunoglobulin

Question 5

What is C3 glomerulonephritis (C3GN)…..?

Answer 5

C3 glomerulonephritis (C3GN) is a related but separate diagnostic category. By light and electron microscopy C3GN usually has features indistinguishable from classic MPGN. Immunofluorescence studies distinguish between the two, with C3GN having only C3 deposition and MPGN having both C3 and immunoglobulin fluorescence.

Question 6

Features of type 2 MPGN…..?

Answer 6

A typical finding is markedly depressed serum C3 complement levels, with normal levels of other complement components.

In many patients with type II MPGN, C3 nephritic factor (anti–C3 convertase antibody) is present

Question 7

Epidemiology of MPGN….?

Answer 7

MPGN is most common in the second decade of life, equally affects males and females

Question 8

Clinical presentation of MPGN ….?

Answer 8

Patients present in equal proportions with nephrotic syndrome, acute nephritic syndrome (hematuria, hypertension, and some level of renal dysfunction), or persistent asymptomatic microscopic hematuria and proteinuria

Question 9

Indications for biopsy include in MPGN ……?

Answer 9

nephrotic syndrome in an older child,

significant proteinuria with microscopic hematuria, and

hypocomplementemia lasting > 2 mo in a child with acute nephritis

Question 10

By 10 yr following onset,———% of patients with MPGN have progressed to end-stage renal disease

Answer 10

50

Question 11

By 20 yr following onset, up to-—-% have lost renal function. In MPGN

Answer 11

90

Question 12

Risk factors for progress to renal failure more rapidly in MPGN …?

Answer 12

Those with nephrotic syndrome and hypertension at the time of presentation