AI Article Synopsis
- MPGN is a rare kidney disease classified based on immunoglobulin and complement deposits found in biopsies, with the study aiming to compare clinical characteristics and outcomes between primary and secondary cases.
- In the studied cohort of 53 cases, 67.9% were classified as primary, with most showing common symptoms like hypertension and edema, while secondary cases frequently presented with hematuria and specific immunoglobulin deposits.
- The study found that 39% of patients achieved remission, and worse kidney outcomes were linked to factors like low serum albumin and high proteinuria at the start.
Article Abstract
Introduction: Membranoproliferative glomerulonephritis (MPGN) is a rare glomerular disease with a variable prognosis. A new classification based on the presence or absence of immunoglobulins and complement deposits in immunofluorescence microscopy (IF) of kidney biopsy has recently been proposed. The objectives of the study were to determine and compare the clinical, laboratory, and histopathological characteristics of those with primary or secondary MPGN, reclassify the primary ones based on IF findings, and evaluate kidney outcomes.
Methods: This was an observational retrospective cohort study carried out in a single center (UNIFESP), based on the data collected from medical records of patients followed from 1996 to 2019.
Results: Of 53 cases of MPGN, 36 (67.9%) were classified as primary and 17 (32.1%) as secondary MPGN. Most patients were hypertensive (84.9%) and had edema (88.7%) and anemia (84.9%); 33 (91.7%) patients classified as primary MPGN were reclassified as immune-complex-mediated and 3 (8.3%) as complement-mediated. The secondary MPGN group had hematuria more frequently (p <0.001) and a higher prevalence of deposits of IgG (p = 0.02) and C1q (p = 0.003). Regarding the outcome, 39% of the patients achieved partial or complete remission. Lower initial serum albumin and higher initial 24-hour proteinuria were factors associated with worst renal prognosis.
Conclusions: According to the new histological classification, the vast majority of MPGN cases were classified as being mediated by immune complexes. There were few differences between primary and secondary MPGN in relation to their clinical and laboratory characteristics.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10139719 | PMC |
| http://dx.doi.org/10.1590/2175-8239-JBN-2022-0016en | DOI Listing |
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Membranoproliferative glomerulonephritis (MPGN) is a rare glomerular disease characterized by mesangial hypercellularity and thickening of the glomerular basement membrane (GBM). MPGN can be idiopathic or associated with malignancy, systemic immune complex disorders and chronic infections. It has rarely been associated with solid organ tumors, such as lung, gastric, breast or prostate cancer.
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