Membranoproliferative Glomerulonephritis- A Disease or a Pattern of Injury? EC23-EC27
Flat No. A11, Snehaneer APT, 1185 Chakgaria, Kolkata, West Bengal, India.
Introduction: Membranoproliferative Glomerulonephritis (MPGN) is a pattern of glomerular injury resulting from wide range of diseases sharing a common pathogenesis and thus presented with large spectrum of clinical presentation starting from slowly progressive subnephrotic range proteinuria to nephritic syndrome and Rapidly Progressive Glomerulonephritis (RPGN).
Aim: The aim of the study was to reanalysis of the aetiological classification of MPGN and its prognostic outcomes.
Materials and Methods: A retrospective, cohort study was conducted including the patients of all age group with MPGN pattern of injury, from February 2018 to August 2018 at a tertiary health care centre of West Bengal, India. All specimens were examined by two nephropathologists at the institute using both light microscope and immunofluorescence microscope. Haematoxylin and Eosin (H&E), Periodic Acid-Schiff (PAS), silver methanamine, Masson’s Trichrome (MT) stained smears were prepared for light microscopy. Specimens for immunofluorescence microscopy were stained using Fluorescein Isothiocyanate (FITC) conjugated polyclonal rabbit anti-sera against human IgG, IgM, IgA, C3, C1q, kappa, lambda. Correlations were evaluated using Spearman’s rank correlation. p<0.05 was considered as statistically significant. GRAPHPAD PRISM 5 was used for statistical analysis.
Results: From a total of 47 cases, 41 cases in Immunoglobulin associated group, 4 cases in C3 nephropathy group and 2 cases in pauci-immune group were found. Autoimmune diseases had the strongest association followed by infections and dysproteinemia. Severity and chronicity parameters were more prevalent in the immunoglobulin positive group. The pauci-immune group showed maximum vascular involvement, indicating it to arise from a vascular pathology.
Conclusion: MPGN is not a single disease entity instead this pattern of injury could be seen in a variety of diseased condition.