Diffuse proliferative glomerulonephritis (DPGN) is a term used to describe a distinct histologic form of glomerulonephritis common to various types of systemic inflammatory diseases, including autoimmune disorders (eg, systemic lupus erythematosus [SLE]), vasculitis syndromes (eg, granulomatosis with polyangiitis), and infectious processes.
What is diffuse proliferative glomerulonephritis (dpgn)?
Diffuse proliferative glomerulonephritis (DPGN) is a histopathologic classification of glomerulonephritis (GN) characterized by an increased cellular proliferation affecting > 50% of the glomeruli. Mesangial, endothelial, and epithelial cells are notably increased.
What is acute proliferative glomerulonephritis?
Acute proliferative glomerulonephritis is a disorder of the small blood vessels of the kidney.
What is Mesangial proliferative glomerulonephritis?
Summary Summary. Mesangial proliferative glomerulonephritis (MPGN) is a condition that affects the kidneys. Many experts consider it a variant of minimal change disease, but some experts believe it is a separate condition.
Is diffuse proliferative glomerulonephritis the worst outcome in childhood-onset Lupus nephritis?
"Diffuse proliferative glomerulonephritis does not determine the worst outcome in childhood-onset lupus nephritis: a 23-year experience in a single centre". Nephrology Dialysis Transplantation. 24 (9): 2729–2734. doi: 10.1093/ndt/gfp173.
What causes diffuse proliferative glomerulonephritis?
The most common associated disease of DPGN is severe systemic lupus erythematosus(SLE). Specifically, Lupus nephritis class IV. The other commonly associated disease is Immunoglobulin A (IgA) nephropathy. Post-infectious glomerulonephritis can also be caused by bacterial or viral infections.
What is diffuse mesangial proliferative glomerulonephritis?
Mesangial proliferative glomerulonephritis (MPGN) is a condition that affects the kidneys. Many experts consider it a variant of minimal change disease, but some experts believe it is a separate condition.
Is diffuse proliferative glomerulonephritis nephritic or nephrotic?
This, combined with increased cellular proliferation and involvement of more than 50% of glomeruli, makes it diffuse proliferative glomerulonephritis (DPGN), which can present with either nephrotic or non-nephrotic range proteinuria as well as hematuria.
What are the signs and symptoms of glomerulonephritis?
SymptomsPink or cola-colored urine from red blood cells in your urine (hematuria)Foamy or bubbly urine due to excess protein in the urine (proteinuria)High blood pressure (hypertension)Fluid retention (edema) with swelling evident in your face, hands, feet and abdomen.Urinating less than usual.Nausea and vomiting.More items...•
How do you get glomerulonephritis?
Causes of glomerulonephritis Glomerulonephritis is often caused by a problem with your immune system. Sometimes it's part of a condition such as systemic lupus erythematosus (SLE) or vasculitis. In some cases, it can be caused by infections, such as: HIV.
What causes mesangial cell proliferation?
Aberrant proliferation of mesangial cells (MCs) is a common finding in a number of diseases that can lead to end-stage renal failure. A variety of initial insults, which may be metabolic (as in diabetic nephropathy), or immunological (as in IgA disease and lupus nephritis), can cause uncontrolled MC proliferation.
What do you mean by glomerulonephritis?
(gloh-MAYR-yoo-loh-neh-FRY-tis) A condition in which the tissues in the kidney become inflamed and have problems filtering waste from the blood. Glomerulonephritis may be caused by infection, inflammatory conditions (such as lupus), certain genetic conditions, and other diseases or conditions.
Is glomerulonephritis the same as lupus nephritis?
Lupus nephritis is an inflammation of the kidneys caused by systemic lupus erythematosus (SLE), an autoimmune disease. It is a type of glomerulonephritis in which the glomeruli become inflamed.
What does acute proliferative glomerulonephritis mean?
Acute glomerulonephritis (AGN) comprises a specific set of kidney diseases in which an immunologic mechanism triggers inflammation and proliferation of glomerular tissue that can result in damage to the basement membrane, mesangium, or capillary endothelium.
What are three 3 risk factors for glomerulonephritis?
Things that may raise the risk are:A family history of kidney disease.Past or current kidney problems.Having other health problems such as diabetes and high blood pressure.Taking certain medicines.Exposure to toxins.
Is glomerulonephritis can be cured?
There's no specific way to treat chronic glomerulonephritis. To help healing and prevent more damage to the kidneys, a doctor might recommend that someone: eat a healthy diet with less protein, potassium, phosphorus, and salt.
What is the most common cause of glomerulonephritis?
What causes acute glomerulonephritis? The acute disease may be caused by infections such as strep throat. It may also be caused by other illnesses, including lupus, Goodpasture's syndrome, Wegener's disease, and polyarteritis nodosa. Early diagnosis and prompt treatment are important to prevent kidney failure.
What does acute proliferative glomerulonephritis mean?
Acute glomerulonephritis (AGN) comprises a specific set of kidney diseases in which an immunologic mechanism triggers inflammation and proliferation of glomerular tissue that can result in damage to the basement membrane, mesangium, or capillary endothelium.
What are the types of glomerulonephritis?
There are two types of glomerulonephritis—acute and chronic....The early symptoms of the acute disease are:puffiness of your face in the morning.blood in your urine (or brown urine)urinating less than usual.
Is MPGN curable?
There's no cure for the disease. Treatment focuses on controlling your symptoms and slowing the progression of the disease.
What is mesangium in kidney?
The Mesangium: Cells and Matrix. The mesangium with its associated cells and matrix is an arborizing structure that supports the glomerular capillary loops but is continuous with the JGA that lies at the junction of the afferent and efferent arterioles and the macula densa of the distal tubule.
Overview
Diffuse proliferative glomerulonephritis (DPGN) is a type of glomerulonephritis that is the most serious form of renal lesions in SLE and is also the most common, occurring in 35% to 60% of patients. In absence of SLE, DPGN pathology looks more like Membranoproliferative glomerulonephritis
In DPGN Most of the glomeruli show endothelial and mesangial proliferation, affecting the entire gl…
Signs and Symptoms
Symptoms can be caused directly from DPGN or from a different disease that is causing DPGN. Many of the symptoms, like edema and hypertension, occur due to the decrease in glomerular filtration rate.
Patients can experience general systemic symptoms including fatigue, vomiting, nausea. These would all indicate uremia.
Cause
The cause of diffuse proliferative glomerulonephritis (DPGN) depends on the severity of the disease. DPGN is a secondary disease, in that a disease that a patient already has causes DPGN to occur. The most common associated disease of DPGN is severe systemic lupus erythematosus(SLE). Specifically, Lupus nephritis class IV. The other commonly associated disease is Immunogl…
Pathophysiology
The etiology plays a role in the specific mechanism of DPGN. Usually the deposition of immune-complexes (antigen-antibody complex) that activates the complement system are involved. The antibodies that form immune complexes deposits or they bind directly to the nonglomerular antibodies present. Immune-complexes are combinations of DNA, anti-dsDNA ubiquitin, and other proteins in DPGN that are associated with lupus nephritis. C1q, the first component of the compl…
Diagnosis
The presentation of all types glomerulonephritis are the same. If a patient is suspected to have DPGN, a blood and urine test will be done first. A urine test will be done to determine if there is protein or blood in the urine. A blood test will be to measure the levels of creatine in the blood. An ultrasound will be done to see if there is inflammation of the kidneys and to look for blockages.
A kidney biopsy is the most important diagnostic tool. With a biopsy, the sample will be looked at
Treatment
Treatment of DPGN depends on the severity of the disease. An optimal treatment for DPGN is immunosuppressive therapy. Two common immunosuppressive drugs used to treat DPGN are cyclophosphamide (CYC) and mycophenolate mofetil (MMF) if the DPGN is caused by SLE. CYC and MMF both preserve the renal function in patients with SLE and DPGN. CYC and MMF hav…
Prognosis
Prognosis is determined by the stage of the disease. Aggressive therapy is recommended to avoid progressing to end-stage renal disease (ESRD), which is a strong possibility. About 10% of DPGN patients will go into ESRD.
If the biopsy shows the presence of crescents, tubule-interstitial injury with inflammation atrophy and fibrosis, the outcome is worse. Other factors that will influence the survival rate are the seve…
Epidemiology
DPGN prevalence varies among races. Whites are the less likely to have DPGN (12-33%); while African Americans (40-69%), Hispanics (36-61%), and Asians (47-53%) are more likely to develop it.
Men are more likely to develop a more aggressive disease than women. However, women are nine times more likely to develop DPGN.