Show Summary Details
Page of

Mesangiocapillary glomerulonephritis 

Mesangiocapillary glomerulonephritis

Chapter:
Mesangiocapillary glomerulonephritis
Author(s):

Peter W. Mathieson

DOI:
10.1093/med/9780199204854.003.210806_update_001

Update:

Novel therapies aimed at complement inhibition, e.g. eculizumab, offer exciting potential in this group of diseases, but clinical experience is very limited.

Updated on 25 May 2011. The previous version of this content can be found here.
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2015. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy).

date: 27 March 2017

Mesangiocapillary glomerulonephritis (MCGN)—which is synonymous with membranoproliferative glomerulonephritis—is diagnosed when renal biopsy reveals glomeruli with a characteristic lobular appearance. Immunohistology and electron microscopy allow further subdivision into three patterns, types I, II (also called dense deposit disease), and III. Clinical presentation is with proteinuria (sometimes nephrotic syndrome) and/or haematuria; hypertension and/or impairment of excretory kidney function may be associated.

Aetiology and pathogenesis—MCGN can be a primary idiopathic form of glomerulonephritis, but also (especially type I) occurs as a secondary complication, especially of infections, e.g. hepatitis C virus, or of systemic diseases, e.g. systemic lupus erythematosus. All forms are characterized by activation of the complement system, with the pattern of activation differing in the three types. There is good evidence that complement activation is of pathogenetic importance, at least in type II MCGN, which is closely associated with the presence of an IgG autoantibody called nephritic factor that activates the alternative pathway of complement. Such activation may also directly injure fat cells (leading to association with partial lipodystrophy), and possibly be responsible for drusen in the eye, which is associated with age-related macular degeneration.

Management and prognosis—the prognosis may be good if an underlying cause can be identified and eradicated, but there is no proven form of therapy for the ‘primary’ forms of the disease, although all patients should have their blood pressure aggressively managed. Overall, renal survival in MCGN is about 50% at 10 years from diagnosis. There is a high rate of recurrence of the disease in renal transplants.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can''t find the answer there, please contact us.