Renal

Membranous Glomerulonephritis

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Pathology

Slowly progression nephrotic syndrome caused by immune complex deposition and glomerular inflammation. Most common in adults.

Aetiology

Idiopathic 
Infection: Streptococcus viridans, HBC, mumps, malaria, syphilis
Malignancy: Melanoma, lymphoma and lung cancer
Autoimmune: SLE, rheumatoid arthritis
Drugs: Gold, penicillamine, heroin

Signs

Marked pitting oedema, ascites and pleural effusions

Symptoms

Swollen legs, weight gain, lethargy, shortness of breath.

Investigations

Bloods: FBC, U&E, LFT’s, lipid profile glucose, myeloma screen, ANA
MSU: Urine dipstick and protein: creatinine ratio
Renal Biopsy: Thickened basement membrane with spikes detected on the 
epithelial aspect using silver staining

Treatment

Medical: Steroids, immunosuppression and dialysis if renal failure evident.

Prognosis

Young female patients have the best prognosis.
Overall, 30% remission, 25% relapse, 25% slow progression, 20% end stage renal failure
Renal failure, renal vein thrombosis

Key Facts

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Key References

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