Membranoproliferative Glomerulonephritis: A Clinicopathologic Study

Abstract

Summary Light and electron microscopic changes are described in three children with apparently diffuse glomerulonephritis in the subacute and chronic stages. Case 1 is a classic case of membrano-proliferative glomerulonephritis (MPG) with low serum complement and predominantly subendothelial osmiophilic deposits with mesangial interposition as well as immunologically proven deposits of complement. In spite of massive morphological changes and metamorphosis to lobular glomerulonephritis the patient recovered clincally. The second case is considered to be an atypical form of MPG there is great similarity to membranous (epimembranous) glomerulonephritis. However, the pronounced proliferative changes, especially in the subacute phase, do not allow this diagnosis. Classification of the third case with little cellular proliferation and few deposits as well as severe lesions of the glomerular basement membrane was first difficult. The electron microscopic changes proove an Alport' Syndrome. In all three cases no previous disease was known. Streptococcal and viral infections are suggested as the cause in the available literature. However, an agent must be considered that is active over a long period of time while being of low pathogenicity. In many cases diagnosis can only be made by electron microscopy.