Proposed classification of MPGN^[1-3]

MPGN: membranoproliferative glomerulonephritis; Ig: immunoglobulin; TTP: thrombotic thrombocytopenic purpura; HUS: hemolytic-uremic syndrome; C3GN: C3 glomerulonephritis; DDD: dense deposit disease.
* In rare cases, patients with MPGN caused by monoclonal gammopathy may present with isolated C3 deposits with no staining for immunoglobulins by routine immunofluorescence staining. Immunofluorescence of formalin-fixed paraffin embedded tissue after protease digestion may reveal the presence of masked glomerular monoclonal immunoglobulin deposits.

References:

Sethi S, Fervenza FC. Membranoproliferative glomerulonephritis--a new look at an old entity. N Engl J Med 2012; 366:1119.
Fervenza FC, Sethi S, Glassock RJ. Idiopathic membranoproliferative glomerulonephritis: does it exist? Nephrol Dial Transplant 2012; 27:4288.
Glassock RJ, Fervenza FC. C3 glomerulopathies and "idiopathic" immune complex membranoproliferative glomerulonephritis (MPGN). In: Treatment of Primary Glomerulonephritis, 3rd ed, Ponticelli C, Glassock RJ (Eds), Oxford University Press, Oxford 2019.

Algorithm created by Sanjeev Sethi, MD, PhD.

Graphic 86556 Version 4.0

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Proposed classification of MPGN[1-3]​

Proposed classification of MPGN^[1-3]