A 38-year-old woman has been feeling lethargic for 4 months. On physical examination, she is afebrile, and her blood pressure is 140/90 mm Hg. Laboratory findings show the serum creatinine level is 5.8 mg/dL. C3 nephritic factor is present in serum, resulting in hypocomplementemia, and the ANA test result is negative. Urinalysis shows 2+ blood and 1+ protein. A renal biopsy is done; microscopic examination shows hypercellular glomeruli and prominent ribbonlike deposits along the lamina densa of the glomerular basement membrane. Which of the following forms of glomerulonephritis is most likely to be present in this patient?
Dense deposit disease (formerly membranoproliferative glomerulonephritis type II) usually leads to hematuria, and half of the cases end in chronic renal failure. The term chronic glomerulonephritis (GN) often is used when sclerosis of many glomeruli is present with no clear cause. Membranous nephropathy is often accompanied by proteinuria but less likely hematuria and is characterized by thickening of only the basement membrane and small electron-dense deposits. Postinfectious GN is often characterized by a hypercellular glomerulus with infiltration of polymorphonuclear leukocytes, but no basement membrane thickening. A rapidly progressive GN is marked by crescents forming in the Bowman space.
Chronic glomerulonephritis
Dense deposit disease
Membranous nephropathy
Postinfectious glomerulonephritis
Kidney