Membranoproliferative glomerulonephritis (MPGN) is synonymous with mesangiocapillary glomerulonephritis and refers to light microscopic appearances of a kidney biopsy in which there are increased mesangial cells and matrix with thickening of the glomerular capillary walls, often with a double contour appearance. MPGN represents morphological appearances caused by a wide range of diseases, most of which are systemic and involve activation of the immune system. It commonly presents as nephrotic syndrome, alternatively with proteinuria, haematuria, and varying degrees of hypertension and renal dysfunction. MPGN was historically characterized into types 1–3 according to the location of immune deposits, but a more useful classification is by whether the underlying disorder results in prominent glomerular immunoglobulin deposition (with secondary complement deposited) or if there is glomerular complement, but scanty or no immunoglobulin deposited. The immunoglobulin group includes MPGN caused by infections, autoimmunity, cryoglobulinaemia, and paraprotein production. The complement group (C3 glomerulopathy) includes dense deposit disease and other complement disorders. Similar light microscopic appearances without deposition of immunoglobulin or complement are sometimes seen in patients with chronic thrombotic microangiopathies. Management and prognosis depend on aetiology.
Chapter. 5657 words. Illustrated.
Subjects: Nephrology ; Surgery
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