Membranoproliferative glomerulonephritis diagnostic study of choice: Difference between revisions

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==Overview==
==Overview==
== Diagnostic study of choice ==
=== Study of choice ===
* Renal biopsy is the gold standard diagnostic test for the diagnosis of membranoproilferative glomerulonephritis<ref name="pmid22435371">{{cite journal| author=Sethi S, Fervenza FC| title=Membranoproliferative glomerulonephritis--a new look at an old entity. | journal=N Engl J Med | year= 2012 | volume= 366 | issue= 12 | pages= 1119-31 | pmid=22435371 | doi=10.1056/NEJMra1108178 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22435371  }} </ref>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<ref name="pmid25607108">{{cite journal| author=Bridoux F, Leung N, Hutchison CA, Touchard G, Sethi S, Fermand JP et al.| title=Diagnosis of monoclonal gammopathy of renal significance. | journal=Kidney Int | year= 2015 | volume= 87 | issue= 4 | pages= 698-711 | pmid=25607108 | doi=10.1038/ki.2014.408 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25607108  }} </ref> 
* 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<ref name="pmid2662048">{{cite journal| author=Bourke E, Campbell WG, Piper M, Check IJ| title=Hypocomplementemic proliferative glomerulonephritis with C3 nephritic-factor-like activity in multiple myeloma. | journal=Nephron | year= 1989 | volume= 52 | issue= 3 | pages= 231-7 | pmid=2662048 | doi=10.1159/000185648 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2662048  }} </ref> 
====== 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 ==

Revision as of 22:11, 25 July 2018

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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