Membranous Nephropathy

(Membranous glomerulonephritis)

As membranous glomerulonephritis (MGN) is defined as the deposition of immune complexes in the glomerular basement membrane (GBM) thickening under the same. The cause is generally unknown, although there are secondary forms, which are due to medications, infections, autoimmune disorders and cancer diseases. One of the manifestations has a gradual onset with edema and severe proteinuria with normal urine sediment, normal renal function and normal to elevated blood pressure. The diagnosis is made by renal biopsy. A spontaneous remission is common. The treatment of patients at high risk for progression is generally with corticosteroids and cyclophosphamide or chlorambucil.

The phospholipase A2 receptor type M (PLA2R) at the glomerular podocyte was identified as a major target antigen in the deposited immune complexes.

As membranous glomerulonephritis (MGN) is defined as the deposition of immune complexes in the glomerular basement membrane (GBM) thickening under the same. The cause is generally unknown, although there are secondary forms, which are due to medications, infections, autoimmune disorders and cancer diseases. One of the manifestations has a gradual onset with edema and severe proteinuria with normal urine sediment, normal renal function and normal to elevated blood pressure. The diagnosis is made by renal biopsy. A spontaneous remission is common. The treatment of patients at high risk for progression is generally with corticosteroids and cyclophosphamide or chlorambucil. The phospholipase A2 receptor type M (PLA2R) at the glomerular podocyte was identified as a major target antigen in the deposited immune complexes. A membranous nephropathy (MN) primarily affects adults, where it is a common cause of nephrotic syndrome. Etiology A MN is idiopathic normally but may be secondary to one of the following: medication (. Eg gold, penicillamine, NSAIDs) infections (eg hepatitis B or C virus infection, syphilis, HIV infection.) Autoimmune diseases (z. B. SLE) thyroiditis cancer have Parasitic diseases (eg. as malaria, schistosomiasis, leishmaniasis) depending on the age about 4-20% of patients an underlying cancer (including solid carcinomas of the lung, colon, stomach, the breast or kidney; Hodgkin or non-Hodgkin’s lymphoma, chronic lymphocytic leukemia and melanoma). The MGN rarely occurs in children and is usually then by hepatitis B virus infection or SLE related. Renal vein thrombosis is more common in MN and is usually asymptomatic, but may present with flank pain, hematuria and hypertension obviously. It can progress to pulmonary embolism. Symptoms and signs Patients typically stand out because of edema and proteinuria in the nephrotic range and occasionally by microscopic hematuria and hypertension. Symptoms and signs of a disorder that causes MN (z. B. a cancer) may be present initially. Diagnostic kidney biopsy examination for secondary causes The diagnosis is obtained by development of nephrotic syndrome, particularly in patients in whom possible causes for MN are present. The diagnosis is confirmed by biopsy. Proteinuria is at 80% in the nephrotic range. It will be carried out laboratory tests as they are induced for nephrotic syndrome. The GFR, when measured, is normal or reduced. The immune complexes are located under the electron microscope as dense deposits represent (Electron microscopic characteristics in immunological glomerular diseases.). In the initial stage dense subepithelial deposits occur, with peaks ( “spikes”) on the lamina densa between the deposits. Later deposits are added within the basement membrane and lead to a marked thickening of the membrane. A diffuse granular pattern of IgG deposits shows along the basement membrane without cell proliferation, exudation or necrosis. Electron microscopic characteristics in immunological glomerular diseases. Membranous nephropathy (density deposits) Figure provided by Agnes Fogo, M.D., and the American Journal of Kidney Disease, Atlas of Renal Pathology (see www.ajkd.org). var model = {thumbnailUrl: ‘/-/media/manual/professional/images/membranous_nephropathy_dense_deposits_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/-/media/manual/professional/images/membranous_nephropathy_dense_deposits_high_de.jpg?la = de & thn = 0 ‘, title:’ membranous nephropathy (density deposits) ‘, description:’ u003Ca id = “v38396934 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “” para “”medium size u003e u003cp u003eSubepitheliale dense deposits at later stage I disease transmission electron microscope ( u003cspan class = “” symbol “” u003e x u003c / span u003e10.200). u003c / p u003e u003c / div u003e ‘credits’ figure provided by Agnes Fogo

Health Life Media Team

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