Which of these is the characteristic feature of membranoproliferative glomerulonephritis ?
Ans. is `c i.e., Splitting of glomerular basement membraneBoth the features mentioned in the options d & c are present in membranoproliferative glomerulonephritis. Membranoproliferative glomerulonephritis Membranoproliferative glomerulonephritis (MPGN) is characterized by alteration in GBM, proliferation of glomerular cells and leukocytic infiltration.o Because the proliferation is predominantly in the mesangium, a frequently used. Synonym is mesangiocapillary glomerulonephritis.o MPGN is divided into three major types on the basis of distinct ultrastructural, immunofluorescent, and pathologic findings ?(i) Type I(ii) Type II (Dens-deposit disease)(iii) TypelllOn light microscope, All types have following similar features.(i) The glomeruli are hypercellular ---> Due to exocapillary and endocapillary proliferation.(ii) The glomeruli have lobular appearance accentuated by the proliferating mesangial cells and increased mesangial matrix.(iii) Parietal epithelial crescent in many cases(iv) GBM is thickened, which is most evident in the peripheral capillary loops.(v) The glomelular capillary wall shows a double contour or tram track appearance because of duplication of basement membrane as a result of new basement membrane synthesis.(vi) Within the basement membrane there is interposition of cellular elements that give rise to the appearance of split basement membrane.o Type I and II MPGN differ in their ultrastructural features. Type I --> Subendothelial deposits. Type II --> Intramembranous deposition.Type I disease (most common) Type II disease (Dens deposit disease) Type III diseaseIdiopathic o Idiopathic o Idiopathico Subacute bacterial endocarditis o C3 nephritic factor associated o Complement factor deficiencySystemic lupus erythematosus o Paial lipodystrophyHepatitis CMixed cryoglubulinemiao Hepatitis Bo Cancer: lung, breast, ovary
Sub epithelial deposits
Foamy cells
Splitting of glomerular basement membrane
All