eMedicine Specialties > Nephrology > Glomerular Diseases

Glomerulonephritis, Membranoproliferative: Multimedia

Author: Pranay Kathuria, MD, MBBS, FACP, FASN, Chief, Section of Nephrology, Associate Professor of Medicine, Associate Director, Clinical Research Center, Schusterman Center, University of Oklahoma College of Medicine
Coauthor(s): Martin Senitko, MD, Fellow, Department of Internal Medicine, Division of Nephrology, University of Texas Southwestern Medical Center; Sandeep Singh, MD, Fellow, Department of Internal Medicine, Division of Nephrology, University of Texas Southwestern Medical Center
Contributor Information and Disclosures

Updated: Feb 26, 2010

Multimedia

Membranoproliferative glomerulonephritis (MPGN) t...Media file 1: Membranoproliferative glomerulonephritis (MPGN) type I. Glomerulus with lobular accentuation from increased mesangial cellularity. A segmental increase occurs in the mesangial matrix, and the peripheral capillary walls are thickened (hematoxylin and eosin stained section; original magnification X 250). Courtesy of John A. Minielly, MD.
Membranoproliferative glomerulonephritis (MPGN) t...

Membranoproliferative glomerulonephritis (MPGN) type I. Glomerulus with lobular accentuation from increased mesangial cellularity. A segmental increase occurs in the mesangial matrix, and the peripheral capillary walls are thickened (hematoxylin and eosin stained section; original magnification X 250). Courtesy of John A. Minielly, MD.

Membranoproliferative glomerulonephritis (MPGN) t...Media file 2: Membranoproliferative glomerulonephritis (MPGN) type I. Electron microscopy of prominent, glomerular, subendothelial, immune-type electron deposits (original magnification X 11,400). Courtesy of John A. Minielly, MD.
Membranoproliferative glomerulonephritis (MPGN) t...

Membranoproliferative glomerulonephritis (MPGN) type I. Electron microscopy of prominent, glomerular, subendothelial, immune-type electron deposits (original magnification X 11,400). Courtesy of John A. Minielly, MD.

Membranoproliferative glomerulonephritis (MPGN) t...Media file 3: Membranoproliferative glomerulonephritis (MPGN) type II. Electron microscopy of glomerular basement membrane, intramembranous, somewhat linear, electron dense deposit (ie, dense deposit disease; original magnification X 11,400). Courtesy of John A. Minielly, MD.
Membranoproliferative glomerulonephritis (MPGN) t...

Membranoproliferative glomerulonephritis (MPGN) type II. Electron microscopy of glomerular basement membrane, intramembranous, somewhat linear, electron dense deposit (ie, dense deposit disease; original magnification X 11,400). Courtesy of John A. Minielly, MD.

Membranoproliferative glomerulonephritis (MPGN) t...Media file 4: Membranoproliferative glomerulonephritis (MPGN) type I. Glomerulus with mesangial interposition producing a double contouring of basement membranes, which, in areas, appear to surround subendothelial deposits (Jones silver methenamine–stained section; original magnification X 400). Courtesy of John A. Minielly, MD.
Membranoproliferative glomerulonephritis (MPGN) t...

Membranoproliferative glomerulonephritis (MPGN) type I. Glomerulus with mesangial interposition producing a double contouring of basement membranes, which, in areas, appear to surround subendothelial deposits (Jones silver methenamine–stained section; original magnification X 400). Courtesy of John A. Minielly, MD.

Membranoproliferative glomerulonephritis (MPGN) t...Media file 5: Membranoproliferative glomerulonephritis (MPGN) type I. Immunofluorescent stained section. Intense, peripheral, glomerular, capillary loop deposition of immunoglobulin G (IgG) in an interrupted linear pattern corresponding to extensive subendothelial immune deposits (original magnification X 400). Courtesy of John A. Minielly, MD.
Membranoproliferative glomerulonephritis (MPGN) t...

Membranoproliferative glomerulonephritis (MPGN) type I. Immunofluorescent stained section. Intense, peripheral, glomerular, capillary loop deposition of immunoglobulin G (IgG) in an interrupted linear pattern corresponding to extensive subendothelial immune deposits (original magnification X 400). Courtesy of John A. Minielly, MD.

More on Glomerulonephritis, Membranoproliferative

Overview: Glomerulonephritis, Membranoproliferative
Differential Diagnoses & Workup: Glomerulonephritis, Membranoproliferative
Treatment & Medication: Glomerulonephritis, Membranoproliferative
Follow-up: Glomerulonephritis, Membranoproliferative
Multimedia: Glomerulonephritis, Membranoproliferative
References

References

  1. Lorenz EC, Sethi S, Leung N, et al. Recurrent membranoproliferative glomerulonephritis after kidney transplantation. Kidney Int. Feb 3 2010;[Medline].

  2. Hanko JB, Mullan RN, O'Rourke DM, et al. The changing pattern of adult primary glomerular disease. Nephrol Dial Transplant. Oct 2009;24(10):3050-4. [Medline].

  3. Izzedine H, Sene D, Cacoub P, et al. Kidney diseases in HIV/HCV-co-infected patients. AIDS. Jun 19 2009;23(10):1219-26. [Medline].

  4. Skerka C, Licht C, Mengel M, et al. Autoimmune forms of thrombotic microangiopathy and membranoproliferative glomerulonephritis: Indications for a disease spectrum and common pathogenic principles. Mol Immunol. Sep 2009;46(14):2801-7. [Medline].

  5. Masai R, Wakui H, Komatsuda A, et al. Characteristics of proliferative glomerulo-nephritis with monoclonal IgG deposits associated with membranoproliferative features. Clin Nephrol. Jul 2009;72(1):46-54. [Medline].

  6. Nasr SH, Satoskar A, Markowitz GS, et al. Proliferative glomerulonephritis with monoclonal IgG deposits. J Am Soc Nephrol. Sep 2009;20(9):2055-64. [Medline].

  7. Arikan H, Koc M, Cakalagaoglu F, et al. Histopathological changes and tumour necrosis factor-alpha, transforming growth factor-beta and tenascin expression in patients with primary type I membranoproliferative glomerulonephritis in remission. Nephrology (Carlton). Apr 2009;14(2):219-26. [Medline].

  8. Jones G, Juszczak M, Kingdon E, et al. Treatment of idiopathic membranoproliferative glomerulonephritis with mycophenolate mofetil and steroids. Nephrol Dial Transplant. Dec 2004;19(12):3160-4. [Medline].

  9. Iitaka K, Moriya S, Nakamura S, et al. Long-term follow-up of type III membranoproliferative glomerulonephritis in children. Pediatr Nephrol. May 2002;17(5):373-8. [Medline].

  10. Anders D, Agricola B, Sippel M, et al. Basement membrane changes in membranoproliferative glomerulonephritis. II. Characterization of a third type by silver impregnation of ultra thin sections. Virchows Arch A Pathol Anat Histol. Oct 27 1977;376(1):1-19. [Medline].

  11. Braun MC, West CD, Strife CF. Differences between membranoproliferative glomerulonephritis types I and III in long-term response to an alternate-day prednisone regimen. Am J Kidney Dis. Dec 1999;34(6):1022-32. [Medline].

  12. Abbas NA, Pitt MA, Green AT, et al. Successful treatment of hepatitis B virus (HBV)-associated membranoproliferative glomerulonephritis (MPGN) with alpha interferon. Nephrol Dial Transplant. May 1999;14(5):1272-5. [Medline].

  13. Alaniz C, Brosius FC 3rd, Palmieri J. Pharmacologic management of adult idiopathic nephrotic syndrome. Clin Pharm. Jun 1993;12(6):429-39. [Medline].

  14. Andresdottir MB, Assmann KJ, Hoitsma AJ, et al. Recurrence of type I membranoproliferative glomerulonephritis after renal transplantation: analysis of the incidence, risk factors, and impact on graft survival. Transplantation. Jun 15 1997;63(11):1628-33. [Medline].

  15. Appel GB, Cook HT, Hageman G, et al. Membranoproliferative glomerulonephritis type II (dense deposit disease): an update. J Am Soc Nephrol. May 2005;16(5):1392-403. [Medline].

  16. Bennett WM, Fassett RG, Walker RG, et al. Mesangiocapillary glomerulonephritis type II (dense-deposit disease): clinical features of progressive disease. Am J Kidney Dis. Jun 1989;13(6):469-76. [Medline].

  17. Bruchfeld A, Lindahl K, Stahle L, et al. Interferon and ribavirin treatment in patients with hepatitis C-associated renal disease and renal insufficiency. Nephrol Dial Transplant. Aug 2003;18(8):1573-80. [Medline].

  18. Burkholder PM, Marchand A, Krueger RP. Mixed membranous and proliferative glomerulonephritis. A correlative light, immunofluorescence, and electron microscopic study. Lab Invest. Nov 1970;23(5):459-79. [Medline].

  19. Cameron JS. Glomerulonephritis in renal transplants. Transplantation. Nov 1982;34(5):237-45. [Medline].

  20. Cameron JS, Ogg CS, Turner DR, et al. Mesangiocapillary glomerulonephritis and persistent hypocomplementemia. Perspect Nephrol Hypertens. 1973;1 Pt 1:541-56. [Medline].

  21. Cameron JS, Turner DR, Heaton J, et al. Idiopathic mesangiocapillary glomerulonephritis. Comparison of types I and II in children and adults and long-term prognosis. Am J Med. Feb 1983;74(2):175-92. [Medline].

  22. Cansick JC, Lennon R, Cummins CL, et al. Prognosis, treatment and outcome of childhood mesangiocapillary (membranoproliferative) glomerulonephritis. Nephrol Dial Transplant. Nov 2004;19(11):2769-77. [Medline].

  23. Cattran DC, Cardella CJ, Roscoe JM, et al. Results of a controlled drug trial in membranoproliferative glomerulonephritis. Kidney Int. Feb 1985;27(2):436-41. [Medline].

  24. Conjeevaram HS, Hoofnagle JH, Austin HA, et al. Long-term outcome of hepatitis B virus-related glomerulonephritis after therapy with interferon alfa. Gastroenterology. Aug 1995;109(2):540-6. [Medline].

  25. D'Amico G, Ferrario F. Mesangiocapillary glomerulonephritis. J Am Soc Nephrol. Apr 1992;2(10 Suppl):S159-66. [Medline].

  26. D'Amico G, Fornasieri A. Cryoglobulinemic glomerulonephritis: a membranoproliferative glomerulonephritis induced by hepatitis C virus. Am J Kidney Dis. Mar 1995;25(3):361-9. [Medline].

  27. Daghestani L, Pomeroy C. Renal manifestations of hepatitis C infection. Am J Med. Mar 1999;106(3):347-54. [Medline].

  28. Davis AE, Schneeberger EE, Grupe WE, et al. Membranoproliferative glomerulonephritis (MPGN type I) and dense deposit disease (DDD) in children. Clin Nephrol. May 1978;9(5):184-93. [Medline].

  29. Donadio JV Jr, Anderson CF, Mitchell JC 3rd, et al. Membranoproliferative glomerulonephritis. A prospective clinical trial of platelet-inhibitor therapy. N Engl J Med. May 31 1984;310(22):1421-6. [Medline].

  30. Donadio JV Jr, Offord KP. Reassessment of treatment results in membranoproliferative glomerulonephritis, with emphasis on life-table analysis. Am J Kidney Dis. Dec 1989;14(6):445-51. [Medline].

  31. Duvall-Young J, Short CD, Raines MF, et al. Fundus changes in mesangiocapillary glomerulonephritis type II: clinical and fluorescein angiographic findings. Br J Ophthalmol. Nov 1989;73(11):900-6. [Medline].

  32. Garini G, Allegri L, Vaglio A, et al. Hepatitis C virus-related cryoglobulinemia and glomerulonephritis: pathogenesis and therapeutic strategies. Ann Ital Med Int. Apr-Jun 2005;20(2):71-80. [Medline].

  33. Habib R, Antignac C, Hinglais N, et al. Glomerular lesions in the transplanted kidney in children. Am J Kidney Dis. Sep 1987;10(3):198-207. [Medline].

  34. Habib R, Kleinknecht C, Gubler MC, et al. Idiopathic membranoproliferative glomerulonephritis in children. Report of 105 cases. Clin Nephrol. Jul-Aug 1973;1(4):194-214. [Medline].

  35. Haddad M, Lau K, Butani L. Remission of membranoproliferative glomerulonephritis type I with the use of tacrolimus. Pediatr Nephrol. Oct 2007;22(10):1787-91. [Medline].

  36. Hariharan S, Adams MB, Brennan DC, et al. Recurrent and de novo glomerular disease after renal transplantation: a report from Renal Allograft Disease Registry (RADR). Transplantation. Sep 15 1999;68(5):635-41. [Medline].

  37. Harmankaya O, Basturk T, Ozturk Y, et al. Effect of acetylsalicylic acid and dipyridamole in primary membranoproliferative glomerulonephritis type I. Int Urol Nephrol. 2001;33(3):583-7. [Medline].

  38. Hill PA, Desmond M. Membranoproliferative glomerulonephritis type II (dense deposit disease) in association with monoclonal gammopathy. Nephrology (Carlton). Aug 2007;12(4):419-20. [Medline].

  39. Johnson RJ, Gretch DR, Couser WG, et al. Hepatitis C virus-associated glomerulonephritis. Effect of alpha-interferon therapy. Kidney Int. Dec 1994;46(6):1700-4. [Medline].

  40. Johnson RJ, Willson R, Yamabe H, et al. Renal manifestations of hepatitis C virus infection. Kidney Int. Nov 1994;46(5):1255-63. [Medline].

  41. Jungers P, Chauveau D. Pregnancy in renal disease. Kidney Int. Oct 1997;52(4):871-85. [Medline].

  42. Levin A. Management of membranoproliferative glomerulonephritis: evidence-based recommendations. Kidney Int Suppl. Jun 1999;70:S41-6. [Medline].

  43. Levy Y, George J, Yona E, et al. Partial lipodystrophy, mesangiocapillary glomerulonephritis, and complement dysregulation. An autoimmune phenomenon. Immunol Res. Aug 1998;18(1):55-60. [Medline].

  44. Licht C, Schlötzer-Schrehardt U, Kirschfink M, et al. MPGN II--genetically determined by defective complement regulation?. Pediatr Nephrol. Jan 2007;22(1):2-9. [Medline].

  45. Lindahl K, Schvarcz R, Bruchfeld A, et al. Evidence that plasma concentration rather than dose per kilogram body weight predicts ribavirin-induced anaemia. J Viral Hepat. Jan 2004;11(1):84-7. [Medline].

  46. Mathew TH. Recurrence of disease following renal transplantation. Am J Kidney Dis. Aug 1988;12(2):85-96. [Medline].

  47. McEnery PT, McAdams AJ, West CD. The effect of prednisone in a high-dose, alternate-day regimen on the natural history of idiopathic membranoproliferative glomerulonephritis. Medicine (Baltimore). Nov 1985;64(6):401-24. [Medline].

  48. Meyers CM, Seeff LB, Stehman-Breen CO, et al. Hepatitis C and renal disease: an update. Am J Kidney Dis. Oct 2003;42(4):631-57. [Medline].

  49. Meyers KE, Finn L, Kaplan BS. Membranoproliferative glomerulonephritis type III. Pediatr Nephrol. Aug 1998;12(6):512-22. [Medline].

  50. Misiani R, Bellavita P, Fenili D, et al. Interferon alfa-2a therapy in cryoglobulinemia associated with hepatitis C virus. N Engl J Med. Mar 17 1994;330(11):751-6. [Medline].

  51. Morzycka M, Croker BP Jr, Siegler HF, et al. Evaluation of recurrent glomerulonephritis in kidney allografts. Am J Med. Apr 1982;72(4):588-98. [Medline].

  52. Neary JJ, Conlon PJ, Croke D, et al. Linkage of a gene causing familial membranoproliferative glomerulonephritis type III to chromosome 1. J Am Soc Nephrol. Aug 2002;13(8):2052-7. [Medline].

  53. Ramos EL, Tisher CC. Recurrent diseases in the kidney transplant. Am J Kidney Dis. Jul 1994;24(1):142-54. [Medline].

  54. Rennke HG. Secondary membranoproliferative glomerulonephritis. Kidney Int. Feb 1995;47(2):643-56. [Medline].

  55. Sansonno D, De Re V, Lauletta G, et al. Monoclonal antibody treatment of mixed cryoglobulinemia resistant to interferon alpha with an anti-CD20. Blood. May 15 2003;101(10):3818-26. [Medline].

  56. Singh A, Tejani C, Tejani A. One-center experience with cyclosporine in refractory nephrotic syndrome in children. Pediatr Nephrol. Jan 1999;13(1):26-32. [Medline].

  57. Smith KD, Alpers CE. Pathogenic mechanisms in membranoproliferative glomerulonephritis. Curr Opin Nephrol Hypertens. Jul 2005;14(4):396-403. [Medline].

  58. Smith RJ, Alexander J, Barlow PN, et al. New approaches to the treatment of dense deposit disease. J Am Soc Nephrol. Sep 2007;18(9):2447-56. [Medline].

  59. Takeda A, Niimura F, Matsutani H. Long-term corticosteroid and dipyridamole treatment of membranoproliferative glomerulonephritis type I in children. Nippon Jinzo Gakkai Shi. Jun 1995;37(6):330-5. [Medline].

  60. Tarshish P, Bernstein J, Tobin JN, et al. Treatment of mesangiocapillary glomerulonephritis with alternate-day prednisone--a report of the International Study of Kidney Disease in Children. Pediatr Nephrol. Mar 1992;6(2):123-30. [Medline].

  61. Varade WS, Forristal J, West CD. Patterns of complement activation in idiopathic membranoproliferative glomerulonephritis, types I, II, and III. Am J Kidney Dis. Sep 1990;16(3):196-206. [Medline].

  62. Walker PD. Dense deposit disease: new insights. Curr Opin Nephrol Hypertens. May 2007;16(3):204-12. [Medline].

  63. West CD. Childhood membranoproliferative glomerulonephritis: an approach to management. Kidney Int. May 1986;29(5):1077-93. [Medline].

  64. West CD. Idiopathic membranoproliferative glomerulonephritis in childhood. Pediatr Nephrol. Jan 1992;6(1):96-103. [Medline].

  65. Williams DG. C3 nephritic factor and mesangiocapillary glomerulonephritis. Pediatr Nephrol. Feb 1997;11(1):96-8. [Medline].

  66. Zauner I, Bohler J, Braun N, et al. Effect of aspirin and dipyridamole on proteinuria in idiopathic membranoproliferative glomerulonephritis: a multicentre prospective clinical trial. Collaborative Glomerulonephritis Therapy Study Group (CGTS). Nephrol Dial Transplant. 1994;9(6):619-22. [Medline].

  67. Zimmerman SW, Moorthy AV, Dreher WH, et al. Prospective trial of warfarin and dipyridamole in patients with membranoproliferative glomerulonephritis. Am J Med. Dec 1983;75(6):920-7. [Medline].

Further Reading

Keywords

membranoproliferative glomerulonephritis, glomerulonephritis, glomerulus, MPGN, membranoproliferative, hypocomplementemia, kidney glomerulus, mesangiocapillary glomerulonephritis, persistent hypocomplementemic glomerulonephritis, parietoproliferative glomerulonephritis, dense deposit disease

Contributor Information and Disclosures

Author

Pranay Kathuria, MD, MBBS, FACP, FASN, Chief, Section of Nephrology, Associate Professor of Medicine, Associate Director, Clinical Research Center, Schusterman Center, University of Oklahoma College of Medicine
Pranay Kathuria, MD, MBBS, FACP, FASN is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine, American Heart Association, American Society of Hypertension, American Society of Nephrology, and National Kidney Foundation
Disclosure: Nothing to disclose.

Coauthor(s)

Martin Senitko, MD, Fellow, Department of Internal Medicine, Division of Nephrology, University of Texas Southwestern Medical Center
Martin Senitko, MD is a member of the following medical societies: American College of Physicians and American Society of Nephrology
Disclosure: Nothing to disclose.

Sandeep Singh, MD, Fellow, Department of Internal Medicine, Division of Nephrology, University of Texas Southwestern Medical Center
Disclosure: Nothing to disclose.

Medical Editor

F John Gennari, MD, Associate Chair for Academic Affairs, Robert F and Genevieve B Patrick Professor, Department of Medicine, University of Vermont College of Medicine
F John Gennari, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, American Federation for Medical Research, American Heart Association, American Physiological Society, American Society for Clinical Investigation, American Society of Nephrology, and International Society of Nephrology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Ajay K Singh, MB, MRCP, MBA, Associate Professor of Medicine, Harvard Medical School; Clinical Chief, Renal Division, Director of Dialysis, Brigham and Women's Hospital; Consulting Staff, Faulkner Hospital
Disclosure: Nothing to disclose.

CME Editor

Rebecca J Schmidt, DO, FACP, FASN, Professor of Medicine, Section Chief, Department of Medicine, Section of Nephrology, West Virginia University School of Medicine
Rebecca J Schmidt, DO, FACP, FASN is a member of the following medical societies: American College of Physicians, American Medical Association, American Society of Nephrology, International Society of Nephrology, National Kidney Foundation, Renal Physicians Association, and West Virginia State Medical Association
Disclosure: Abbott Grant/research funds Speaking and teaching; Genzyme Honoraria Consulting; Amgen Honoraria Speaking and teaching; Ortho Biotech Honoraria Speaking and teaching

Chief Editor

Vecihi Batuman, MD, FACP, FASN, Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Medicine Service, Southeast Louisiana Veterans Health Care System
Vecihi Batuman, MD, FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, and International Society of Nephrology
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.