Mesangial proliferative glomerulonephritis
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| Mesangial proliferative glomerulonephritis | |
|---|---|
| Synonyms | MesPGN |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Hematuria, proteinuria, hypertension, edema |
| Complications | Chronic kidney disease, end-stage renal disease |
| Onset | Variable |
| Duration | Chronic |
| Types | N/A |
| Causes | Infection, autoimmune disease, IgA nephropathy |
| Risks | Genetic predisposition, environmental factors |
| Diagnosis | Urinalysis, kidney biopsy, serum creatinine |
| Differential diagnosis | IgA nephropathy, lupus nephritis, post-infectious glomerulonephritis |
| Prevention | N/A |
| Treatment | Corticosteroids, immunosuppressive therapy, antihypertensive drugs |
| Medication | N/A |
| Prognosis | Variable, depends on underlying cause and response to treatment |
| Frequency | Rare |
| Deaths | Rare, but can lead to kidney failure if untreated |
Mesangial Proliferative Glomerulonephritis (MPGN) is a pathological condition affecting the kidneys, specifically targeting the mesangial cells located within the glomeruli. These cells are integral to the structural support and filtration regulation within the kidney. MPGN is characterized by an increase in the number of mesangial cells (cellular proliferation) and the accumulation of extracellular matrix, leading to the thickening of the glomerular mesangial areas. This condition falls under the broader category of glomerulonephritis, which denotes inflammation and damage to the glomeruli, the filtering units of the kidney.
Causes and Pathogenesis
The exact cause of Mesangial Proliferative Glomerulonephritis can vary. It is often associated with immune system disorders, where the immune system mistakenly attacks the body's own cells and tissues. Conditions such as Systemic Lupus Erythematosus (SLE), IgA Nephropathy (Berger's disease), and infections like Hepatitis B and C can trigger this autoimmune response. The pathogenesis involves the deposition of immune complexes in the mesangial areas, leading to inflammation and proliferation.
Symptoms
Symptoms of MPGN may include:
- Hematuria (blood in urine)
- Proteinuria (protein in urine)
- Edema (swelling), particularly in the legs and feet
- Hypertension (high blood pressure)
- Decreased kidney function
Diagnosis
Diagnosis of Mesangial Proliferative Glomerulonephritis involves a combination of clinical evaluation, laboratory tests, and kidney biopsy. Laboratory tests may show signs of kidney dysfunction, such as elevated serum creatinine levels and abnormal urinalysis results. A kidney biopsy is the definitive method for diagnosing MPGN, allowing for direct observation of the mesangial proliferation and immune deposits.
Treatment
Treatment for MPGN focuses on controlling the symptoms and preventing further kidney damage. This may include:
- Corticosteroids and other immunosuppressive drugs to reduce inflammation and immune response
- Antihypertensive medications to control blood pressure
- Diuretics to manage edema
- Dietary modifications and supportive care
In cases where MPGN progresses to End-Stage Renal Disease (ESRD), dialysis or kidney transplantation may be necessary.
Prognosis
The prognosis for patients with Mesangial Proliferative Glomerulonephritis varies. Factors such as the underlying cause, the extent of kidney damage at the time of diagnosis, and the response to treatment can influence outcomes. Early detection and management are crucial in preventing or slowing the progression to chronic kidney disease.
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Contributors: Prab R. Tumpati, MD