Dense deposit disease: a variant of membranoproliferative glomerulonephritis
R Habib, MC Gubler, C Loirat, HB Maiz, M Levy - Kidney international, 1975 - Elsevier
R Habib, MC Gubler, C Loirat, HB Maiz, M Levy
Kidney international, 1975•ElsevierIt has been demonstrated in previous studies that there are several morphological variants
of membranoproliferative glomerulonephritis (MPGN)[1–3]. In most cases mesangial cell
proliferation and an increase in mesangial matrix are associated with capillary wall
thickening (“classical MPGN”). In some cases, in addition to the previous findings, there is an
accentuation of lobulation of glomerular tufts due to the presence of sclerotic nodules in
most of the centrilobular areas. This is accompanied by peripheral displacement or …
of membranoproliferative glomerulonephritis (MPGN)[1–3]. In most cases mesangial cell
proliferation and an increase in mesangial matrix are associated with capillary wall
thickening (“classical MPGN”). In some cases, in addition to the previous findings, there is an
accentuation of lobulation of glomerular tufts due to the presence of sclerotic nodules in
most of the centrilobular areas. This is accompanied by peripheral displacement or …
It has been demonstrated in previous studies that there are several morphological variants of membranoproliferative glomerulonephritis (MPGN) [1–3]. In most cases mesangial cell proliferation and an increase in mesangial matrix are associated with capillary wall thickening (“classical MPGN”). In some cases, in addition to the previous findings, there is an accentuation of lobulation of glomerular tufts due to the presence of sclerotic nodules in most of the centrilobular areas. This is accompanied by peripheral displacement or obliteration of capillary lumens (lobular GN or “MPGN with lobular pattern”). More or less abundant epithelial crescents may be seen in both variants.
However, analysis of the capillary wall thickening by light and electron microscopy reveals two types of involvement: In the first, thickening of the capillary walls is due to an interposition of mesangial matrix between the endothelium and a normal basement membrane, producing a “double contour” appearance. Electron microscopy, as well as immunofluorescence microscopy, reveals in all cases the presence of abnormal subendothelial deposits. This variety is calledMPGN with subendothelial deposits (SED). In the second, the thickening of the capillary walls is due to the presence of an abnormal dense refractile material located in the basement membrane itself. “Double contours” here are an inconstant finding. This variety warrants the name ofMPGN with dense intramembranous deposits (DIMD); it has recently been calledlaminal glomerulonephritis [4].
These two varieties of MPGN are at present not distinguished one from another in most clinical studies because it may be difficult to recognize MPGN with DIMD on light microscopy. Therefore, with one exception [5], there are no extensive studies dealing with this specific entity.
We observed 44 cases of this variety of MPGN and report here detailed clinical and complement studies, together with histological data in these cases for comparison with 84 cases of MPGN with SED seen during the same period of time.
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