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:
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
- ↑ 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.