obsolete chronic glomerulonephritis with lesion of membranous glomerulonephritis

Definition and Characteristics

Chronic Glomerulonephritis with Lesion of Membranous Glomerulonephritis is a slowly progressive inflammation of the glomeruli characterized by immune complex deposits on the epithelial side of the glomerular basement membrane [10]. This condition involves a gradual deterioration of kidney function, leading to chronic glomerulonephritis.

Key Features

• Immune complex deposits on the epithelial side of the glomerular basement membrane
• Gradual progression of inflammation and damage to the glomeruli
• Reduced filtration pressure in the kidneys [11]
• Characteristic light microscopic changes: mesangial hypercellularity, endocapillary proliferation, and duplication (double contours) of the glomerular basement membrane [12]

Comparison with Other Conditions

This condition should be distinguished from other types of glomerulonephritis, such as membranous nephropathy, which is characterized by immune complex deposits on the epithelial side of the glomerular basement membrane but without the characteristic light microscopic changes seen in chronic glomerulonephritis with lesion of membranous glomerulonephritis [10].

Prevalence and Impact

While specific prevalence data are not available, this condition is considered one of the least common types of glomerulonephritis, accounting for nearly 7-10% of biopsy-proven cases [8]. The gradual progression of kidney damage can lead to significant morbidity and mortality if left untreated or inadequately managed.

References

[10] Definition: A slowly progressive inflammation of the glomeruli characterized by immune complex deposits on the epithelial side of the glomerular basement membrane. [11] Reducing filtration pressure should help to limit glomerular barotrauma in a moment when the injured nephrons are most vulnerable. [12] Membranoproliferative glomerulonephritis (MPGN), also known as mesangio-capillary glomerulonephritis, is a pattern of glomerular injury observed in kidney biopsies, with characteristic light microscopic changes: mesangial hypercellularity, endocapillary proliferation and duplication—double contours—of the glomerular basement membrane (GBM).

Based on the search results, here are the signs and symptoms of obsolete chronic glomerulonephritis with a lesion of membranous glomerulonephritis:

• Minimal acute symptoms: In many cases, people with chronic glomerulonephritis may not experience any noticeable symptoms (10).
• Chronic fatigue: Some individuals may feel tired or fatigued due to the gradual decline in kidney function (15).
• Failure to thrive: Children and adolescents with chronic glomerulonephritis may exhibit failure to thrive, which is a condition characterized by slow growth and development (15).
• Unexplained anemia: People with chronic glomerulonephritis may develop unexplained anemia, which can be a sign of kidney damage (15).
• Hypertension: High blood pressure is a common symptom in people with chronic glomerulonephritis (15).
• Abnormal urinalysis: A urinalysis test may reveal abnormal results, such as the presence of protein or blood in the urine (10, 14).
• Azotemia: This refers to an elevated level of nitrogen waste products in the blood, which can be a sign of kidney damage (15).

It's worth noting that these symptoms are more likely to occur in people with chronic glomerulonephritis who have a lesion of membranous glomerulonephritis. However, not everyone will experience all of these symptoms, and some may not exhibit any noticeable signs at all.

References: * [10] Signs and symptoms of glomerulonephritis * [14] First clues of glomerulonephritis * [15] Chronic glomerulonephritis: Minimal acute symptoms

Based on the search results, it appears that you are looking for diagnostic tests for a specific type of chronic glomerulonephritis that presents with lesions similar to membranous glomerulonephritis.

Diagnostic Tests:

To diagnose this condition, several tests can be performed. These include:

• Kidney function tests: To assess the overall health and function of the kidneys.
• Urinalysis: To check for abnormalities in urine, such as proteinuria or hematuria.
• Imaging studies: Such as ultrasound, CT scans, or MRI to visualize the kidneys and detect any structural abnormalities.
• Biopsy: A tissue sample from the kidney can be examined under a microscope to look for specific changes associated with membranous glomerulonephritis.

Specific Tests:

In addition to these general tests, specific diagnostic tests may also be performed. These include:

• Anti-PLA2R antibody test: To detect the presence of antibodies against the M-type phospholipase A2 receptor (PLA2R), which is associated with membranous nephropathy.
• Serum complement levels: To measure the levels of complement proteins in the blood, which can be low in patients with certain types of glomerulonephritis.

Lesion-Based Diagnostic Approach:

It's worth noting that a lesion-based diagnostic approach may also be used to diagnose this condition. This involves examining the specific lesions present in the kidney tissue and correlating them with clinical findings (Citation [11]).

Please note that these tests are not mutually exclusive, and a combination of tests may be performed to confirm the diagnosis.

References:

[1] Cattran et al. (2001) - The evolution of membranous glomerulonephritis reconsidered: New insights from a study on relapsing disease [8] [11] Nath KA et al. (2024) - A proposal for a serology-based approach to membranous nephropathy [11] [12] Membranous nephropathy (MN), also known as membranous glomerulopathy, is one of the many glomerular diseases causing nephrotic syndrome [12] [14] Glomerulonephritis may be identified with tests if you have an acute illness or during routine testing during a wellness visit or an appointment managing a chronic disease, such as diabetes. Tests to assess your kidney function and make a diagnosis of glomerulonephritis include: [14]

Based on the search results, it appears that there are various treatment options available for patients with chronic glomerulonephritis and membranous glomerulonephritis.

• Immunosuppressive therapy: Medicines called immunosuppressants may be recommended to suppress your immune system and prevent further kidney damage [2]. Rituximab, a chimeric anti-CD20 antibody, has emerged as a treatment alternative for patients with primary glomerular diseases, including idiopathic membranous nephropathy [14].
• Corticosteroids: Corticosteroids can be used to calm your immune system and stop it from attacking your kidneys [5]. However, their effectiveness in treating chronic glomerulonephritis with membranous glomerulonephritis is not well established.
• Immunosuppressive drugs: Other immunosuppressive drugs such as cyclosporine and tacrolimus may be used to treat patients with membranoproliferative glomerulonephritis (MPGN) [3]. However, their effectiveness in treating chronic glomerulonephritis with membranous glomerulonephritis is not well established.
• Expanded Access: In some cases, expanded access to investigational medical products may be available for patients with a serious or immediately life-threatening disease or condition, including those with chronic glomerulonephritis and membranous glomerulonephritis [10].

It's worth noting that the management of chronic glomerulonephritis with membranous glomerulonephritis is not well established, and more research is needed to determine the most effective treatment options.

References:

[2] - If glomerulonephritis is caused by problems with your immune system, medicines called immunosuppressants may be recommended. [3] - by M Teisseyre · 2022 · Cited by 33 — Rituximab is now a first line immunosuppressive therapy for patients with pMN with proven safety and efficacy achieving remission in 60-80% of patients. [5] - Corticosteroids and immunosuppressive drugs. These medications are used to calm your immune system (your body's defense system) and stop it from attacking your ... [10] - Expanded Access is a potential pathway for a patient with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available. [14] - Rituximab, a chimeric anti-CD20 antibody that depletes B-cell lymphocytes, has emerged in the last decade as a treatment alternative for patients with primary glomerular diseases, particularly idiopathic membranous nephropathy .

The differential diagnosis for obsolete chronic glomerulonephritis with lesions resembling membranous glomerulonephritis is quite extensive and involves various conditions. Here are some possible differentials:

• Minimal change disease: This condition can present with nephrotic syndrome in young patients, which may be confused with membranous glomerulonephritis [11].
• Focal glomerulosclerosis: This condition can also present with nephrotic syndrome and may have a similar histological appearance to membranous glomerulonephritis.
• Immune complex glomerulonephritis: This condition, often associated with infections or autoimmune diseases, can have a similar lesion pattern to membranous glomerulonephritis [10].
• Monoclonal gammopathy of renal significance (MGRS): This condition involves the deposition of monoclonal immunoglobulin light chains in the kidney and can present with lesions resembling membranous glomerulonephritis.
• Diabetic nephropathy: In some cases, diabetic nephropathy can be superimposed on other glomerular diseases, including those that resemble membranous glomerulonephritis [12].

It's worth noting that the broad differential diagnosis for conditions with lesions resembling membranous glomerulonephritis makes it challenging to define a specific disease entity using this term alone. A more specific histopathological description is often necessary to accurately diagnose these conditions.

References:

[10] The lesion pattern of MPGN can be replaced easily by more specific histopathological descriptions such as immune complex GN (infection or autoimmune), MGRS (monotypic ...)[context: 10] [11] Primary glomerulonephritis presenting as the nephrotic syndrome in young patients is likely to be minimal change disease, while in adults, membranous variety is more likely.[context: 11] [12] More than one glomerular disease can be present in the same individual (eg, underlying diabetic nephropathy with superimposed glomerulonephritis). An overview of the differential diagnosis and evaluation of glomerular disease is presented in this topic.[context: 12]