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{{Membranoproliferative glomerulonephritis}}
{{CMG}} ; {{AE}}
== Overview ==
Membranoproliferative glomerulonephritis is associated with several diseases that can be categorized in to different groups. The most relevant conditions are chronic infections, autoimmune diseases, chronic liver disease ([[cirrhosis]] and [[alpha1-antitrypsin deficiency]]), chronic and recovered thrombotic microangiopathies, [[Paraprotein]] deposition diseases, and malignant [[neoplasms]] [[Genetic mutations|genetic mutations.]]
== Risk Factors ==
Conditions that increase the risk of MPGN incldude:


== Overview ==
{| class="wikitable"
{{Membranoproliferative glomerulonephritis}}
! colspan="2" |Risk Factor
Membranoproliferative glomerulonephritis is associated with several disease than can categorize in to several groups. The most relevant conditions that have strong evidence behind them to prove the correlation of them with MPGN are included:<ref name=":0">{{Cite journal|last=Fernando C. Fervenza, Sanjeev Sethi and Richard J. Glassock|first=|date=2012|title=Idiopathic membranoproliferative glomerulonephritis: does it exist?|url=|journal=Nephrology Dialysis Transplantation|volume=|pages=|via=}}</ref>
|-
* Chronic infections
!Immune complex–mediated disease
* Autoimmune diseases
|
* Chronic liver disease (cirrhosis and alpha1-antitrypsin deficiency)
==== Autoimmune ====
* Chronic and recovered thrombotic microangiopathies
* [[Systemic lupus erythematosus]] (SLE),
* Paraprotein deposition diseases
* [[Sjögren syndrome]]
* Malignant neoplasms
* [[Rheumatoid arthritis]]
* Genetic mutations
* Inherited [[complement]] deficiencies (in particular, C2 deficiency)
* [[Scleroderma]]
* [[Celiac disease]] 


== Risk factors ==
==== Chronic infections ====
There are too many conditions those are associated with MPGN and each of this disease have their own potential to increase the risk of occurring MPGN.
* Viral – [[Hepatitis B]], [[hepatitis C]], [[cryoglobulinemia]] type II
* Bacterial – [[Endocarditis]], infected ventriculoatrial (or jugular) shunt, multiple visceral [[abscesses]], [[leprosy]]
* Protozoal – Malaria, schistosomiasis
|-
!Thrombotic microangiopathies
|
* Healing phase of [[hemolytic uremic syndrome]] (HUS) and/or [[thrombotic thrombocytopenic purpura]] (TTP)
* Syndromes of circulating [[antiphospholipid (anticardiolipin) antibodies]]
* [[Radiation nephritis]]
* [[Nephropathy]] associated with [[bone marrow transplantation]]
* [[Sickle cell anemia]] and [[polycythemia]]
* Transplant [[glomerulopathy]]
|-
!Paraprotein deposition diseases
|
* [[Glomerulonephropathies]] associated with [[cryoglobulinemia]] type I
* [[Waldenström macroglobulinemia]]
* Immunotactoid [[glomerulopathy]]
* [[Immunoglobulin]] light-chain or heavy-chain deposition diseases
* [[Fibrillary glomerulonephritis]]
* [[Monoclonal gammopathy]] of unknown significance
|-
!Malignant [[neoplasms]]
|
* [[Lymphoma]]
* [[Leukemia]], and carcinoma are associated with a membranoproliferative pattern of renal injury.
|}


Conditions associated with a membranoproliferative pattern of injury are listed as follows:
Conditions associated with a membranoproliferative pattern of injury are listed as follows:
* Immune complex–mediated disease
* Immune complex–mediated disease
:* Idiopathic forms of MPGN or of unknown association<ref name=":0" />
:* Idiopathic forms of MPGN or of unknown association<ref name=":0">{{Cite journal|last=Fernando C. Fervenza, Sanjeev Sethi and Richard J. Glassock|first=|date=2012|title=Idiopathic membranoproliferative glomerulonephritis: does it exist?|url=|journal=Nephrology Dialysis Transplantation|volume=|pages=|via=}}</ref>
:*:* MPGN type I
:*:* MPGN type I
:*:* MPGN type II or dense deposit disease and PLD
:*:* MPGN type II or dense deposit disease and PLD
:*:* MPGN type III
:*:* MPGN type III
:* Autoimmune diseases<ref>{{Cite journal|last=H. Terence Cook and Matthew C. Pickering|first=|date=2014|title=Histopathology of MPGN and C3 glomerulopathies|url=|journal=NATURE REVIEWS NEPHROLOGY|volume=|pages=|via=}}</ref><ref>{{Cite journal|last=MICHELINE LEVY, MARIE-CLAIRE GUBLER, MIREILLE SICH, AGNES BEZIAU, AND RENE HABIB|first=|date=1978|title=lmmunopathology Glomerulonephritis of Membranoproliferative with Subendothelial Deposits|url=|journal=clinical immunology and immunopathology|volume=|pages=|via=}}</ref><ref>{{Cite journal|last=Mårten Segelmark, Thomas Hellmark|first=|date=2010|title=Autoimmune kidney diseases|url=|journal=Elsevier|volume=|pages=|via=}}</ref>
:* Autoimmune diseases<ref>{{Cite journal|last=H. Terence Cook and Matthew C. Pickering|first=|date=2014|title=Histopathology of MPGN and C3 glomerulopathies|url=|journal=NATURE REVIEWS NEPHROLOGY|volume=|pages=|via=}}</ref><ref>{{Cite journal|last=MICHELINE LEVY, MARIE-CLAIRE GUBLER, MIREILLE SICH, AGNES BEZIAU, AND RENE HABIB|first=|date=1978|title=lmmunopathology Glomerulonephritis of Membranoproliferative with Subendothelial Deposits|url=|journal=clinical immunology and immunopathology|volume=|pages=|via=}}</ref><ref>{{Cite journal|last=Mårten Segelmark, Thomas Hellmark|first=|date=2010|title=Autoimmune kidney diseases|url=|journal=Elsevier|volume=|pages=|via=}}</ref>
:*:* Systemic lupus erythematosus (SLE)
:*:* [[Systemic lupus erythematosus]] (SLE)
:*:* Sjögren syndrome
:*:* [[Sjögren syndrome]]
:*:* Rheumatoid arthritis
:*:* [[Rheumatoid arthritis]]
:*:* Inherited complement deficiencies, in particular, C2 deficiency
:*:* Inherited [[complement deficiencies]], in particular, C2 deficiency
:*:* Scleroderma
:*:* [[Scleroderma]]
:*:* Celiac disease
:*:* [[Celiac disease]]
:* Chronic infections
:* Chronic infections<ref>{{Cite journal|last=C Licht, S Heinen, M Jo ́zsi, I Lo ̈schmann, RE Saunders, SJ Perkins, R Waldherr, C Skerka, M Kirschfink, B Hoppe and PF Zipfel|first=|date=2006|title=Deletion of Lys224 in regulatory domain 4 of Factor H reveals a novel pathomechanism for dense deposit disease (MPGN II)|url=|journal=International Society of Nephrology|volume=|pages=|via=}}</ref>
:*:* Viral - Hepatitis B, hepatitis C, and cryoglobulinemia type II
:*:* Viral - [[Hepatitis B]], [[hepatitis C]], and [[cryoglobulinemia]] type II
:*:* Bacterial - Endocarditis, infected ventriculoatrial (or jugular) shunt, multiple visceral abscesses, leprosy
:*:* Bacterial - [[Endocarditis]], [[infected ventriculoatrial (or jugular) shunt]], multiple [[visceral abscesses]], [[leprosy]]
:*:* Protozoal - Malaria, schistosomiasis
:*:* Protozoal - [[Malaria]], [[schistosomiasis]]
:*:* Other infections - Mycoplasma, Lyme Disease<ref>{{Cite journal|last=Dimitrios Kirmizis, MD, Georgios Efstratiadis, MD, Dominiki Economidou, MD, Evdoxia Diza-Mataftsi, MD, Maria Leontsini, MD, and Dimitrios Memmos, MD|first=|date=2004|title=MPGN Secondary to Lyme Disease|url=|journal=American Journal of Kidney Diseases|volume=43|pages=|via=}}</ref>
:*:* Other infections - [[Mycoplasma]], [[Lyme Disease]]<ref>{{Cite journal|last=Dimitrios Kirmizis, MD, Georgios Efstratiadis, MD, Dominiki Economidou, MD, Evdoxia Diza-Mataftsi, MD, Maria Leontsini, MD, and Dimitrios Memmos, MD|first=|date=2004|title=MPGN Secondary to Lyme Disease|url=|journal=American Journal of Kidney Diseases|volume=43|pages=|via=}}</ref>
:* Miscellaneous - Chronic liver disease (cirrhosis and alpha1-antitrypsin deficiency)
:* Miscellaneous - [[Chronic liver disease]] ([[cirrhosis]] and [[alpha1-antitrypsin deficiency]])
* Chronic and recovered thrombotic microangiopathies
* Chronic and recovered thrombotic [[microangiopathies]]
:* Healing phase of hemolytic uremic syndrome and/or thrombotic thrombocytopenic purpura
:* Healing phase of [[hemolytic uremic syndrome]] and/or [[thrombotic thrombocytopenic purpura]]
:* Syndromes of circulating antiphospholipid (anticardiolipin) antibodies
:* Syndromes of circulating [[antiphospholipid (anticardiolipin) antibodies]]
:* Radiation nephritis
:* Radiation [[nephritis]]
:* Nephropathy associated with bone marrow transplantation
:* [[Nephropathy]] associated with [[bone marrow transplantation]]
:* Sickle cell anemia and polycythemia
:* [[Sickle cell anemia]] and [[polycythemia]]
:* Transplant glomerulopathy
:* Transplant [[glomerulopathy]]
* Paraprotein deposition diseases
* [[Paraprotein]] deposition diseases
:* Glomerulonephropathies associated with cryoglobulinemia type I
:* Glomerulonephropathies associated with [[cryoglobulinemia]] type I
:* Waldenström macroglobulinemia
:* [[Waldenström macroglobulinemia]]
:* Immunotactoid glomerulopathy
:* [[Immunotactoid glomerulopathy]]
:* Immunoglobulin light chain or heavy chain deposition diseases
:* [[Immunoglobulin]] light chain or heavy chain deposition diseases
:* Fibrillary glomerulonephritis
:* [[Fibrillary glomerulonephritis]]
* Genetic mutation
* Genetic mutation
** Deletion of Lys224 in regulatory domain 4 of Factor H  
** Deletion of Lys224 in regulatory domain 4 of Factor H  
*** A study demonstrated that a delegation of a single Lys residue (K224) located within the complement regulatory region in domain 4 of Factor H will resulted in defected complement control . Mutant protein purified from the plasma of patients, so on laboratories test they showed severely reduced cofactor and decay-accelerating activity, as well as diminished  attachment to the core complement component C3b. Albeit, cell-binding activity of the mutant protein was normal and comparable to wild-type Factor H.  
*** A study demonstrated that a delegation of a single Lys residue (K224) located within the complement regulatory region in domain 4 of Factor H will resulted in defected complement control . Mutant protein purified from the plasma of patients, so on laboratories test they showed severely reduced cofactor and decay-accelerating activity, as well as diminished  attachment to the core complement component C3b. Albeit, cell-binding activity of the mutant protein was normal and comparable to wild-type Factor H.  
* Malignant neoplasms
* Malignant neoplasms
:* Lymphoma
:* [[Lymphoma]]
:* Leukemia
:* [[Leukemia]]
:* Carcinoma
:* [[Carcinoma]]


==References==
==References==

Latest revision as of 20:52, 6 August 2018

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

Overview

Membranoproliferative glomerulonephritis is associated with several diseases that can be categorized in to different groups. The most relevant conditions are chronic infections, autoimmune diseases, chronic liver disease (cirrhosis and alpha1-antitrypsin deficiency), chronic and recovered thrombotic microangiopathies, Paraprotein deposition diseases, and malignant neoplasms genetic mutations.

Risk Factors

Conditions that increase the risk of MPGN incldude:

Risk Factor
Immune complex–mediated disease

Autoimmune

Chronic infections

Thrombotic microangiopathies
Paraprotein deposition diseases
Malignant neoplasms
  • Lymphoma
  • Leukemia, and carcinoma are associated with a membranoproliferative pattern of renal injury.

Conditions associated with a membranoproliferative pattern of injury are listed as follows:

  • Immune complex–mediated disease
  • Genetic mutation
    • Deletion of Lys224 in regulatory domain 4 of Factor H
      • A study demonstrated that a delegation of a single Lys residue (K224) located within the complement regulatory region in domain 4 of Factor H will resulted in defected complement control . Mutant protein purified from the plasma of patients, so on laboratories test they showed severely reduced cofactor and decay-accelerating activity, as well as diminished attachment to the core complement component C3b. Albeit, cell-binding activity of the mutant protein was normal and comparable to wild-type Factor H.
  • Malignant neoplasms

References

  1. ↑ Fernando C. Fervenza, Sanjeev Sethi and Richard J. Glassock (2012). "Idiopathic membranoproliferative glomerulonephritis: does it exist?". Nephrology Dialysis Transplantation.
  2. ↑ H. Terence Cook and Matthew C. Pickering (2014). "Histopathology of MPGN and C3 glomerulopathies". NATURE REVIEWS NEPHROLOGY.
  3. ↑ MICHELINE LEVY, MARIE-CLAIRE GUBLER, MIREILLE SICH, AGNES BEZIAU, AND RENE HABIB (1978). "lmmunopathology Glomerulonephritis of Membranoproliferative with Subendothelial Deposits". clinical immunology and immunopathology.
  4. ↑ Mårten Segelmark, Thomas Hellmark (2010). "Autoimmune kidney diseases". Elsevier.
  5. ↑ C Licht, S Heinen, M Jo ́zsi, I Lo ̈schmann, RE Saunders, SJ Perkins, R Waldherr, C Skerka, M Kirschfink, B Hoppe and PF Zipfel (2006). "Deletion of Lys224 in regulatory domain 4 of Factor H reveals a novel pathomechanism for dense deposit disease (MPGN II)". International Society of Nephrology.
  6. ↑ Dimitrios Kirmizis, MD, Georgios Efstratiadis, MD, Dominiki Economidou, MD, Evdoxia Diza-Mataftsi, MD, Maria Leontsini, MD, and Dimitrios Memmos, MD (2004). "MPGN Secondary to Lyme Disease". American Journal of Kidney Diseases. 43.

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