Membranous glomerulonephritis causes: Difference between revisions

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{{Membranous glomerulonephritis}}
{{Membranous glomerulonephritis}}


{{CMG}}; {{AE}}  
{{CMG}}; {{AE}} {{SAH}}
 
==Overview==
==Overview==
==Causes==
The main causes of membranous glomerulonephritis are infections like [[hepatitis B]], [[hepatitis C]], [[HIV]], [[syphilis]], [[leprosy]], drugs like [[captopril]], [[penicillin-binding-protein|penicilliamine,]] [[autoimmune disease]]s like [[systemic lupus erythematosus]], [[GBS disease|Guillian-Barre nephropathy]] and neoplastic diseases like [[Hodgkin's Disease|non-hodgkin`s]] [[lymphoma]], [[chronic lymphocytic leukemia]], occasionally [[Lymphoma, large-cell, immunoblastic|hodgkin`s lymphoma]].
The causes of membranous glomerulonephritis are as follows:
* Infectious disease
* Hepatitis B
* Hepatitis C
* secondary and congenital syphilis
* HIV nephropathy
* Schistosomiasis
* Leprosy
* Hydatid disease
* Loaiasis (filaria)
* Quartan malaria
* Drugs and toxicity
* Gold
* Penicilliamine
* Captopril (high doses)
* Formaldehyde
* Probenecid
* nonsteroidal anti-inflammatory drugs
* mercury
* Volatile hydrocarbons
* Autoimmue or collagen-vascular disease
* systemic lupus erythematosus
* Rheumatoid arthritis
* Hashimoto`s thyroiditis
* Primary biliary cirrhosis
* Neoplastic disease
* carcinoma ( lung, breast, stomach, colon, esophagus, melanoma, renal cell, neuroblastoma, carotid body)
* Lymphoproliferative ( non-hodgkin`s lymphoma, chronic lymphocytic leukemia, occasionally hodgkin`s lymphoma)
* Post-renal transplant glomerulopathy.
* Miscellaneous
* Diabetes Mellitus
* sickle cell anemia
* Sarcoidosis
* Weber-christian disease
* Dermatitis herpetiformis
* Bullous pemphigoid
* Myasthenia gravis
* Guillain-Barre nephropathy 
 
 
 
=== Causes of secondary MN ===
'''Hepatitis B'''


The most frequent glomerulopathy in patients infected with hepatitis B virus is MGN followed by membranoproliferative GN. The antigens Core (HBcAg) and e (HBeAg) seem the most important in the pathogenesis of hepatitis B-associated MGN. In these cases the antigens, or their antibodies, are identified in the glomerular immune deposits. It is not clear what is first deposited: the Ag., the Ac. or the Ag-Ac complex previously formed (circulating). Prevalence of MGN in the infection is not known, but in children with MGN the carrier stage is detected in around 20% of cases, with higher rates in endemic countries. In adults the percentage of patients with MGN carrying hepatitis B virus is lower than in children. In GNM cases associated with this infection there are more frequently mesangial hypercellularity, endocapillary proliferation, subendothelial immune deposits, and tubuloreticular endothelial structures (electron microscopy). It is frequent that appears with hypocomplementemia. The prognosis of MGN in hepatitis B patients seem more favorable, with most frequency of remission and less probability of evolution to terminal renal damage.
==Causes:==


'''Hepatitis C'''
=== Life-threatening Causes ===
* Life-threatening causes of membranous glomerulonephritis include:<ref name="pmid10495797">{{cite journal |vauthors=Wasserstein AG |title=Membranous glomerulonephritis |journal=J. Am. Soc. Nephrol. |volume=8 |issue=4 |pages=664–74 |date=April 1997 |pmid=10495797 |doi= |url=}}</ref><ref name="ReichertKoene1998">{{cite journal|last1=Reichert|first1=LJ|last2=Koene|first2=RA|last3=Wetzels|first3=JF|title=Prognostic factors in idiopathic membranous nephropathy|journal=American Journal of Kidney Diseases|volume=31|issue=1|year=1998|pages=1–11|issn=02726386|doi=10.1053/ajkd.1998.v31.pm9428445}}</ref><ref name="TroyanovRoasio2006">{{cite journal|last1=Troyanov|first1=S.|last2=Roasio|first2=L.|last3=Pandes|first3=M.|last4=Herzenberg|first4=A.M.|last5=Cattran|first5=D.C.|title=Renal pathology in idiopathic membranous nephropathy: A new perspective|journal=Kidney International|volume=69|issue=9|year=2006|pages=1641–1648|issn=00852538|doi=10.1038/sj.ki.5000289}}</ref>
**[[Hepatitis B]]
**[[Hepatitis C]]
**[[HIV]]
**[[Lymphoproliferative]]
**[[Lymphoma, small cleaved-cell, follicular|Non-Hodgkin`s lymphoma]]
**[[Chronic lymphocytic leukemia]]
**[[Lymphoma, large-cell, immunoblastic|Hodgkin`s lymphoma]]


In this infection disease also secondary MGN can appear, although membranoproliferative GN is more frequent. In many studies have not been identified antigens of the virus, or Acs against these, in the glomerular deposits. Clinic expression can be similar to idiopathic MGN or it may appear with asymptomatic proteinuria.
=== Common Causes ===


'''Congenital Syphilis'''
==== Infectious Causes ====
* The infectious causes of membranous glomerulonephritis are given below:<ref name="pmid10495797" /><ref name="ReichertKoene1998">{{cite journal|last1=Reichert|first1=LJ|last2=Koene|first2=RA|last3=Wetzels|first3=JF|title=Prognostic factors in idiopathic membranous nephropathy|journal=American Journal of Kidney Diseases|volume=31|issue=1|year=1998|pages=1–11|issn=02726386|doi=10.1053/ajkd.1998.v31.pm9428445}}</ref>
** [[Hepatitis B]]
** [[Hepatitis C]]
** [[HIV]]
** [[Secondary]] and [[congenital]] [[syphilis]]


MGN is a rare complication in congenital syphilis, but it is a well-recognized cause of NS in children with this infection. Other glomerular disease in congenital syphilis include nephritic syndrome and crescentic GN with rapidly progressive disease. We have seen cases with these types of glomerular disease and there is a dramatic improvement with the antibiotic treatment. Several studies have demonstrated the presence of antigens of Treponema pallidum in the immune glomerular deposits.
==== '''Drugs and toxicity''' ====
* The causes related to drug and toxicity are given below:<ref name="pmid10495797" />
** [[Penicillin-binding-protein|Penicilliamine]]
** [[Captopril]] (high doses)
** [[Nonsteroidal anti-inflammatory drugs]] 


'''Systemic Lupus Erythematosis'''
==== Neoplastic causes: ====
* [[Lymphoproliferative disorder|Lymphoproliferative]]
* [[Hodgkin's Disease|Non-hodgkin`s lymphoma]]
* [[chronic lymphocytic leukemia]]
* [[Lymphoma, large-cell, immunoblastic|Hodgkin`s lymphoma]])


the histopathologic presentation is very variable and there is combination of morphologic changes: MGN with subendothelial deposits, endocapillary and/or mesangial proliferation, crescents, combination with characteristics of membranoproliferative GN, and other patterns. In the most recent lupus nephritis classification, pure MGN (class V) is only diagnosed if there are no other active lesions; if there is combination with active lesions it is diagnosed as combination of class V and class III or IV only if there are lesions with membranous characteristics in more than 50% of the tuft in more than 50% of glomeruli. Occasional subepithelial deposits and “spikes” formation are very frequent in class III and IV lupus nephritis. In most of these cases we find C1q glomerular deposits.
=== Less common causes: ===


'''Malignancy'''
=== Infectious causes: ===
* [[Schistosomiasis]]
* [[Leprosy]]
* [[Hydatid disease]]
* [[Loaiasis]] ([[filaria]])
* [[Malaria Vaccine Initiative|Quartan]] [[malaria]]


The neoplasms more frequently associated with MGN are lung, breast, colon, stomach and kidney carcinomas, leukemia and lymphomas (Hodgkin’s and non-Hodgkin’s), but there is information of MGN in many other cancer types. Incidence of cancer in patients with MGN is approximately 1%. The histologic and immunopathologic findings and the clinical presentation are similar to those of idiopathic forms of MGN. The association between MGN and neoplasms is supported by the clinical course, the immune response of the host to the tumor and the glomerular pathology, nevertheless, in very few cases is documented an antigen of the tumor, or its antibody, in glomerular deposits. It is possible that the immune response against the neoplasm, in a propitious genetic context, allow the development of MGN. The prognosis of the glomerulopathy depend on that of the neoplasm. If there are treatment and response of this last one, the MGN tends to disappear.
==== Drug and toxicity: ====
* [[Formaldehyde]]


'''Drugs'''
* [[Hydrocarbons|Volatile]] [[hydrocarbons]]


Exposure to a variety of agents that are primarily used to treat rheumatoid arthritis have been implicated in the development of MN, including nonsteroidal antiinflammatory drugs (NSAIDs), penicillamine, parenteral gold salts, bucillamine, and possibly anti-tumor necrosis factor agents (anti-TNF; etanercept, infliximab, or adalimumab) [67-74]. (See "Overview of the systemic and nonarticular manifestations of rheumatoid arthritis", section on 'Kidney disease' and "NSAIDs: Acute kidney injury (acute renal failure)" and "Overview of biologic agents and kinase inhibitors in the rheumatic diseases".)
==== Neoplastic disease ====
* The neoplastic causes are given below:<ref name="pmid10495797" />
* [[Carcinoma]] ( [[lung]], [[breast]], [[stomach]], [[colon]], [[esophagus]], [[melanoma]], [[renal cell]], [[neuroblastoma]], [[carotid body]])


The association of NSAIDs with MN was illustrated in a study of 125 patients with a biopsy diagnosis of MN [67]. Twenty-nine patients were taking an NSAID, and 13 (10 percent of the study population) fulfilled three criteria suggesting that the NSAID was responsible:
=== Miscellaneous ===
* The other causes are given below<ref name="pmid10495797" />:
* [[Diabetes Mellitus]]
* [[Sickle cell anemia]]
* [[Sarcoidosis]]
* [[Disease agent|Weber-christian disease]]
* [[Dermatitis herpetiformis]]
* [[Bullous pemphigoid]]
* [[Immune System|Mysthenia gravis]]
* [[GBS disease|Guillian-Barre nephropathy]] 


●No other apparent cause for the MN
===Causes by Organ System===
* The causes of membranous glomerulonephritis are given below:<ref name="pmid10495797">{{cite journal |vauthors=Wasserstein AG |title=Membranous glomerulonephritis |journal=J. Am. Soc. Nephrol. |volume=8 |issue=4 |pages=664–74 |date=April 1997 |pmid=10495797 |doi= |url=}}</ref><ref name="ReichertKoene1998">{{cite journal|last1=Reichert|first1=LJ|last2=Koene|first2=RA|last3=Wetzels|first3=JF|title=Prognostic factors in idiopathic membranous nephropathy|journal=American Journal of Kidney Diseases|volume=31|issue=1|year=1998|pages=1–11|issn=02726386|doi=10.1053/ajkd.1998.v31.pm9428445}}</ref><ref name="TroyanovRoasio2006">{{cite journal|last1=Troyanov|first1=S.|last2=Roasio|first2=L.|last3=Pandes|first3=M.|last4=Herzenberg|first4=A.M.|last5=Cattran|first5=D.C.|title=Renal pathology in idiopathic membranous nephropathy: A new perspective|journal=Kidney International|volume=69|issue=9|year=2006|pages=1641–1648|issn=00852538|doi=10.1038/sj.ki.5000289}}</ref>


●Resolution of proteinuria within 1 to 36 weeks of discontinuing NSAIDs
{| style="width:80%; height:100px" border="1"
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular'''
| style="width:75%" bgcolor="Beige" ; border="1" | No underlying causes
|-
| bgcolor="LightSteelBlue" | '''Chemical/Poisoning'''
| bgcolor="Beige" | [[Hydrocarbons|Volatile]] [[hydrocarbons]]
|-
|- bgcolor="LightSteelBlue"
| '''Dental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| bgcolor="Beige" | [[Bullous pemphigoid]]
|-
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| bgcolor="Beige" | [[Captopril]], [[Penicillin-binding-protein|Penicilliamine]]
|-
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| bgcolor="Beige" | [[Diabetes mellitus]], [[Hashimoto's|Hashimoto]]`s [[thyroiditis]]
|-
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| bgcolor="Beige" | [[Genetic Diseases, Inborn|Weber-christian disease]]
|-
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| bgcolor="Beige" | [[Sickle cell anemia]]
|-
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| bgcolor="Beige" |  [[Hepatitis B]],  [[Hepatitis C]], [[secondary]] and [[congenital]] [[syphilis]], [[HIV]] [[nephropathy]], [[Schistosomiasis]], [[Leprosy]], [[Hydatid disease]], [[Loaiasis]] ([[filaria]]), [[Malaria Vaccine Initiative|Quartan]] [[malaria]]
|-
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| bgcolor="Beige" | [[Rheumatoid arthritis]]
|-
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| bgcolor="Beige" | [[GBS disease|Guillain-Barre nephropathy]], [[Myasthenia gravis]]
|-
|- bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| bgcolor="Beige" | [[Lymphoma, large-cell, immunoblastic|Non-Hodgkin`s Lymphoma]], [[Chronic Lymphocytic Leukemia]], [[Lymphoma, large-cell, immunoblastic|Hodgkin`s Lymphoma]]
|-
|- bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
| bgcolor="Beige" | [[Captopril]], [[Gold]], [[Penicillin-binding proteins|Penicilliamine]]
|-
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| bgcolor="Beige" | [[Sarcoidosis]]
|-
|- bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| bgcolor="Beige" | [[Rheumatoid arthritis]], [[Autoimmune|Mysthenia gravis]], [[Primary biliary cirrhosis]], [[GBS disease|Guillain-Barre nephropathy]], [[Systemic lupus erythematosis]]
|-
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| bgcolor="Beige" | No underlying causes
|-
|}


●No recurrence of proteinuria at follow-up (5 months to 13 years)
===Causes in Alphabetical Order===
 
Many of the patients who developed MN had been treated with diclofenac, but probably any NSAID can be involved [67], including cyclooxygenase (COX)-2 inhibitors [69]. (See "NSAIDs: Acute kidney injury.


List the causes of the disease in alphabetical order:<ref name="pmid10495797">{{cite journal |vauthors=Wasserstein AG |title=Membranous glomerulonephritis |journal=J. Am. Soc. Nephrol. |volume=8 |issue=4 |pages=664–74 |date=April 1997 |pmid=10495797 |doi= |url=}}</ref><ref name="ReichertKoene1998">{{cite journal|last1=Reichert|first1=LJ|last2=Koene|first2=RA|last3=Wetzels|first3=JF|title=Prognostic factors in idiopathic membranous nephropathy|journal=American Journal of Kidney Diseases|volume=31|issue=1|year=1998|pages=1–11|issn=02726386|doi=10.1053/ajkd.1998.v31.pm9428445}}</ref><ref name="TroyanovRoasio2006">{{cite journal|last1=Troyanov|first1=S.|last2=Roasio|first2=L.|last3=Pandes|first3=M.|last4=Herzenberg|first4=A.M.|last5=Cattran|first5=D.C.|title=Renal pathology in idiopathic membranous nephropathy: A new perspective|journal=Kidney International|volume=69|issue=9|year=2006|pages=1641–1648|issn=00852538|doi=10.1038/sj.ki.5000289}}</ref>
<div style="-moz-column-count:3; column-count:3;">
* [[Bullous pemphigoid]]
* [[Captopril]]
* [[Dermatitis herpetiformis]]
* [[Diabetes Mellitus]]
* [[Formaldehyde]]
* [[GBS disease|Guillain-Barre nephropathy]]
* [[Thyroid Disease|Hashimoto`s thyroiditis]]
* [[Hepatitis B]]
* [[Hepatitis C]]
* [[Hydatid disease]]
* [[HIV]]
* [[Leprosy]]
* [[Loaiasis]] [[filaria|(filaria]])
* [[Lymphoproliferative]] ([[Lymphoma, large-cell, immunoblastic|non-hodgkin`s lymphoma]], [[chronic]] [[lymphocytic]] [[leukemia]], occasionally [[Lymphoma, large-cell, immunoblastic|hodgkin`s lymphoma]])
* [[Immune System|Mysthenia gravis]]
* [[Nonsteroidal anti-inflammatory drugs]]
* [[Penicillin-binding-protein|Penicilliamine]]
* [[Primary biliary cirrhosis]]
* [[Malaria Vaccine Initiative|Quartan]] [[malaria]]
* [[Sarcoidosis]]
* [[Systemic lupus erythematosus]]
* [[Sickle cell anemia]]
* [[Schistosomiasis]]
* [[Syphilis]] ([[Secondary]] and [[congenital]])
* [[Disease agent|Weber-christian disease]]
* [[Volatile anesthetic|Volatile hydrocarbons]]
</div>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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[[Category: (name of the system)]]
 
[[Category:Nephrology]]
[[Category:Up-to-date]]

Latest revision as of 22:41, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Ahsan Hussain, M.D.[2]

Overview

The main causes of membranous glomerulonephritis are infections like hepatitis B, hepatitis C, HIV, syphilis, leprosy, drugs like captopril, penicilliamine, autoimmune diseases like systemic lupus erythematosus, Guillian-Barre nephropathy and neoplastic diseases like non-hodgkin`s lymphoma, chronic lymphocytic leukemia, occasionally hodgkin`s lymphoma.

Causes:

Life-threatening Causes

Common Causes

Infectious Causes

Drugs and toxicity

Neoplastic causes:

Less common causes:

Infectious causes:

Drug and toxicity:

Neoplastic disease

Miscellaneous

Causes by Organ System

  • The causes of membranous glomerulonephritis are given below:[1][2][3]
Cardiovascular No underlying causes
Chemical/Poisoning Volatile hydrocarbons
Dental No underlying causes
Dermatologic Bullous pemphigoid
Drug Side Effect Captopril, Penicilliamine
Ear Nose Throat No underlying causes
Endocrine Diabetes mellitus, Hashimoto`s thyroiditis
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic Weber-christian disease
Hematologic Sickle cell anemia
Iatrogenic No underlying causes
Infectious Disease Hepatitis B, Hepatitis C, secondary and congenital syphilis, HIV nephropathy, Schistosomiasis, Leprosy, Hydatid disease, Loaiasis (filaria), Quartan malaria
Musculoskeletal/Orthopedic Rheumatoid arthritis
Neurologic Guillain-Barre nephropathy, Myasthenia gravis
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Non-Hodgkin`s Lymphoma, Chronic Lymphocytic Leukemia, Hodgkin`s Lymphoma
Ophthalmologic No underlying causes
Overdose/Toxicity Captopril, Gold, Penicilliamine
Psychiatric No underlying causes
Pulmonary Sarcoidosis
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy Rheumatoid arthritis, Mysthenia gravis, Primary biliary cirrhosis, Guillain-Barre nephropathy, Systemic lupus erythematosis
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

List the causes of the disease in alphabetical order:[1][2][3]

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Wasserstein AG (April 1997). "Membranous glomerulonephritis". J. Am. Soc. Nephrol. 8 (4): 664–74. PMID 10495797.
  2. ↑ 2.0 2.1 2.2 2.3 Reichert, LJ; Koene, RA; Wetzels, JF (1998). "Prognostic factors in idiopathic membranous nephropathy". American Journal of Kidney Diseases. 31 (1): 1–11. doi:10.1053/ajkd.1998.v31.pm9428445. ISSN 0272-6386.
  3. ↑ 3.0 3.1 3.2 Troyanov, S.; Roasio, L.; Pandes, M.; Herzenberg, A.M.; Cattran, D.C. (2006). "Renal pathology in idiopathic membranous nephropathy: A new perspective". Kidney International. 69 (9): 1641–1648. doi:10.1038/sj.ki.5000289. ISSN 0085-2538.

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