Over the past 30 years, the top five types of PGN were immunoglobulin A nephropathy (IgAN; 24.3%), mesangial proliferative glomerulonephritis
(MsPGN; 10.5%), membranous nephropathy (MN; 12.6%), minimal change disease (MCD; 9.8%), and focal segmental glomerulosclerosis (FSGS; 4.6%), and the top four types of SGN were lupus nephritis (LN; 8.6%), Henoch-Schonlein purpura glomerulonephritis (4.1%), hepatitis B virus-associated glomerulonephritis (HBV-GN; 2.6%), and diabetic nephropathy (DN; 1.6%).
Most chronic glomerulonephritis involves mesangial proliferative glomerulonephritis
(MesPGN), for which the characteristic is an increase of mesangial cells .
The final diagnosis was MPO-ANCAassociated necrotizing and crescentic glomerulonephritis on a background of mesangial proliferative glomerulonephritis
consistent with class II lupus nephritis (ISN/RPS).
Bowen-Pope, "Proliferating and migrating mesangial cells responding to injury express a novel receptor proteintyrosine phosphatase in experimental mesangial proliferative glomerulonephritis
," The Journal of Biological Chemistry, vol.
IgAN, primary IgA nephropathy; HTN, hypertensive nephrosclerosis; MN, membranous nephropathy; MCD, minimal change disease; TIN, tubulointerstitial nephritis; RA, renal amyloidosis; MPGN, mesangial proliferative glomerulonephritis
; CrGN, crescentic glomerulonephritis; ATN, acute tubular necrosis; CIN, chronic interstitial nephritis; FSGS, focal segmental glomerular sclerosis.
The elevated excretion of neopterin with urine was also noticed in adults with mesangial proliferative glomerulonephritis
However, according to their report, membranous glomerulonephritis is a rare pathological finding in PGNMID, like mesangial proliferative glomerulonephritis
. In the present report, we report a case of membranous glomerulonephritis associated with focal mesangial proliferation with monoclonal IgG deposits.
Predominant histomorpholo- gical patterns were mesangial proliferative nephritis (focal mesangial proliferative nephritis 14 (12.6%) and diffuse mesangial proliferative nephritis 13 (11.7%) End Stage renal disease focal segmental glo- merulosclerosis minimal change disease followed by amyloidosis membranoproliferative glomerulone- phritis membranous glomerulopathy chronic transplant rejection diabetic nephropathy and rapidly progressive glomerulonephritis found on renal biopsy.Conclusion: In adult population mesangial proliferative glomerulonephritis
is the leading histopatho- logical entity in our set up followed by end stage renal disease.
Pathology was consistent with collapsing focal segmental glomerulosclerosis (Figures 1 and 2) with diffuse mesangial proliferative glomerulonephritis
, consistent with lupus nephritis class II along with tubular degenerative changes.
(19,20) There were six reports of mesangial proliferative glomerulonephritis
. This histological finding is usually due to IgA nephropathy or lupus nephritis.
A renal biopsy sample showed endocapillary and mesangial proliferative glomerulonephritis
with abundant focal semilunes (Figure 2, panel A).
Mesangial proliferative glomerulonephritis
combined with splenic infarction has been reported.[sup] As splenic artery is a terminal artery without communicating branch, splenic infarction has a tendency to spontaneous healing.