- Membranoproliferative glomerulonephropathy (MPGN) exhibits a variety of clinical presentations, including acute GN, nephrotic syndrome, and asymptomatic hematuria and proteinuria. The diagnosis should be suspected if these clinical findings are associated with low complement levels.
- Hepatitis C (HCV) accounts for most cases of MPGN and is often associated with cryoglobulinemia.
- SLE can cause the pathologic finding of MPGN. Idiopathic MPGN is a rare disorder. Fifty to sixty percent of patients with idiopathic MPGN progress to ESRD by 10-15 years.
- Pathology includes mesangial proliferation with collapse of the capillary loop and alterations of the GBM with subendothelial (type I) or intramembranous (type II) electron-dense deposits. Mesangial interposition with the GBM may result in the appearance of tram tracking.
- For adult idiopathic MPGN, treatment has not been shown to improve disease-free survival, although the use of corticosteroids in children likely stabilizes disease. HCV-associated MPGN may improve with successful antiviral therapy including pegylated interferon alfa and ribavirin, unless the GFR is <50 mL/min, in which case only npegylated interferon alfa is currently approved.