Membranoproliferative glomerulonephritis diagnostic study of choice

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Overview

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
    • Hepatits 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

  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.
  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.
  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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