WHAT IS MPGN Membranoproliferative glomerulonephritis (MPGN) is a disease that affects the glomeruli, or filters, of the kidneys. Most instances of MPGN are caused by other diseases or disorders, including autoimmune diseases (such as systemic lupus erythematosis), chronic infections (like hepatitis B or more commonly hepatitis C), monoclonal immunoglobulin deposition diseases, and hereditary diseases. However, a few cases are idiopathic, or of unknown cause. The idiopathic type of MPGN is seen more commonly in persons aged 8-40 MICROSCOPIC TYPES There are three histologic (microscopic) types of MPGN, each of which has a different appearance under the microscope. Type I– Discrete immune complexes are found in the mesangium and subendothelial space. Immune complexes are combinations of antigens and antibodies which bind to each other and then become lodged in the kidney. This activates the immune system, which causes inflammation and damage to the kidney itself. Type II – This is also called dense deposit disease. When viewed under the microscope, continuous, dense ribbon-like deposits are found along the basement membranes of the glomeruli, tubules, and Bowman’s capsule. Type III – This is also an immune complex disease, similar to Type I. However, the immune complexes are found in the subepithelial space, and there is disruption of the glomerular basement membrane with large open areas. What are the symptoms? The symptoms of MPGN are very similar to those of a focal glomerulonephritis. Specifically, patients have hematuria (blood in the urine), either macroscopic, which can be seen by the naked eye, or microscopic. Many of the red blood cells are dysmorphic (malformed or misshapen). In addition, mild or severe proteinuria can be found (including the nephrotic syndrome). What is the treatment? When MPGN is associated with another condition or disease, it is usually resolved by successfully treating the associated condition or disease. However, the optimal treatment of idiopathic MPGN is not entirely known. The type of treatment will depend on the type of proteinuria that the patient has. If a patient has proteinuria that is “non-nephrotic”, then specific immunosuppressive therapy may not be necessary, as the long-term outcome is not life-threatening. However, patients with nephrotic-range proteinuria will typically be treated with steroids (Prednisone).



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