Membranoproliferative glomerulonephritis diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Jogeet Singh Sekhon, M.D. [2]

Overview

Renal biopsy is considered the gold standard diagnostic test for MPGN.Light, electron and immunoflourescnce microscopy are performed.Other diagnostic tests are doen to look for the cause of the disease.

Diagnostic study of choice

Study of choice

Renal biopsy is the gold standard diagnostic test for the diagnosis of membranoproilferative glomerulonephritis^[1]19908070 .
Light microscopy, electron dense microscopy and immunofluorescence are performed on the renal biopsy sample.
Other tests include
- CBC,
- Urine analysis
- Renal function tests
- Serum ANA
- Serum complement profile
- Antistreptolysin-O titres
- Hepatitis B and Hepatitis C
- Blood cultures
- Serum and urine electrophoresis^[2]
These tests must be performed when a patient presents with anorexia, malaise, edema, secondary hypertension and oliguria.

Diagnostic results

Light microscopy

The findings of glomerulus with increased mesangial cellularity, increase in the mesangial matrix, and thickened peripheral capillary walls are confirmatory for the disease.

Electron microscopy

Immune deposits in the mesangium and subendothelial space.

Immunoflourescence

Presence of immunoglbulins or complement in the mesangium depending on the cause.

CBC

Normocytic normochromic anemia

Urine analysis

May show proteinuria

Renal function tests

Serum creatinine and BUN might be elevated

Complement profile

C3, C4 and CH50 levels for classic complement pathway
AH50 levels for alternate complement pathway
C3 nephritic factor levelsj^[3]

Serum ANA

Postive serum ANA means autoimmune disease etiology

Blood culture

Chronic bacterial infections

Diagnostic criteria

There is no established diagnostic criteria for membranoproliferative glomerulonephritis

References

↑ Sethi S, Fervenza FC (2012). "Membranoproliferative glomerulonephritis--a new look at an old entity". N Engl J Med. 366 (12): 1119–31. doi:10.1056/NEJMra1108178. PMID 22435371.
↑ Bridoux F, Leung N, Hutchison CA, Touchard G, Sethi S, Fermand JP; et al. (2015). "Diagnosis of monoclonal gammopathy of renal significance". Kidney Int. 87 (4): 698–711. doi:10.1038/ki.2014.408. PMID 25607108.
↑ Bourke E, Campbell WG, Piper M, Check IJ (1989). "Hypocomplementemic proliferative glomerulonephritis with C3 nephritic-factor-like activity in multiple myeloma". Nephron. 52 (3): 231–7. doi:10.1159/000185648. PMID 2662048.

[pmid22435371-1] Sethi S, Fervenza FC (2012). "Membranoproliferative glomerulonephritis--a new look at an old entity". N Engl J Med. 366 (12): 1119–31. doi:10.1056/NEJMra1108178. PMID 22435371.

[pmid25607108-2] Bridoux F, Leung N, Hutchison CA, Touchard G, Sethi S, Fermand JP; et al. (2015). "Diagnosis of monoclonal gammopathy of renal significance". Kidney Int. 87 (4): 698–711. doi:10.1038/ki.2014.408. PMID 25607108.

[pmid2662048-3] Bourke E, Campbell WG, Piper M, Check IJ (1989). "Hypocomplementemic proliferative glomerulonephritis with C3 nephritic-factor-like activity in multiple myeloma". Nephron. 52 (3): 231–7. doi:10.1159/000185648. PMID 2662048.

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