Three Pathological Types in Mesangial Proliferative Glomerulonephritis(MPGN)

Membranoproliferative glomerulonephritis (MPGN) refers to a group kidney disorders which cause damage renal glomerular filters. Glomerular filtering cells filtrate bloodstream, removes wastes and stop nutrients from escaping. Glomerulonephritis is caused by deposits of immune complexes on mesangium, thickening glomerular basement membrane and damaging the glomeruli. MPGN is divided into three groups, type 1, type 2 and type 3, based on the pattern of inflammation seen in the filters. In some cases, there is an overlap of features so it is hard to define a specific type of MPGN for every patient. The following will introduce the three main pathological types of MPGN.

MPGNⅠ

Immune complexes are deposited under endothelium of renal capillaries. There exists obvious thickening of glomerular basilar membrane. Immune complex insert in between endothelium and mesangium, causing bordening of mesangium. Electron dense deposition under endothelium can be observed.

MPGN II

MPGN II is a kidney disorder that stops the kidneys from filtering waters from blood. The immune system for those with MPGN II doesn’t work properly to rid the immune complex deposits. The deposits are located in the filtering part of the kidneys, or the glomerulus. This will cause glomerular cells to inflamed and impaired. Immune complex deposits in MPGN II are massive, hence, it is also named as Dense Deposit Disease (DDD).

MPGN Ⅲ

Massive deposits under glomerular endothelium, under epithelium or glomerular mesangium. It can be divided into two sub-types---Burkholder type and Strife-Ander type. In Burkholder type, electron dense deposits are detectable on endothelium and epithelium. In Strife-Anders subtype, electron dense of various sizes penetrate the layer of glomerular basement membrane.

With medical research progressing, it is accepted by most researchers that type 2 MPGN differs from the other two types in histological characteristics, electric structural changes and pathogenesis. It is thought that type 2 MPGN is a special type of glomerulonephritis which is caused by abnormal activation of complements and alternative pathways.

Routine treatment for MPGN mainly includes immunosuppressive medicines, ARB or ACEI medicines to delay progression and control symptoms. Blood plasma exchange by removing the immune complexes, antibodies and meditative factors is a latest medical technique that has shown therapeutic effects in treating MPGN.