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Membranoproliferative Glomerulonephritis (MPGN)

Immune-Complex and Complement-Mediated Glomerular Disease

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Membranoproliferative Glomerulonephritis (MPGN)?

MPGN is a histologic pattern featuring mesangial hypercellularity, thickened capillary loops with double-contour (tram-tracking) appearance, and endocapillary proliferation.

New classification based on immunofluorescence: immune-complex MPGN (Ig + C3), complement-mediated (C3-only = C3 glomerulonephritis and dense deposit disease), and monoclonal immunoglobulin deposition.

Underlying etiologies include chronic infections (hepatitis C, hepatitis B, endocarditis), autoimmune disease (SLE, cryoglobulinemia), monoclonal gammopathies, and complement dysregulation.

Presents with mixed nephritic and nephrotic features and often progresses to chronic kidney disease.

Symptoms

Proteinuria, often nephrotic range
Microscopic or gross hematuria
Hypertension
Peripheral edema
Low serum complement (especially C3) often persistent
Features of underlying systemic illness (hepatitis, cryoglobulinemia, gammopathy)

Risk Factors

Chronic hepatitis C or B infection
Endocarditis or indwelling infected devices
Cryoglobulinemia
Autoimmune disease (SLE, Sjögren's)
Monoclonal gammopathy
Inherited complement mutations or antibodies to complement regulators

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Mixed nephritic-nephrotic picture with persistent low complement
  • Systemic symptoms suggesting hepatitis, cryoglobulinemia, or gammopathy
  • Progressive decline in kidney function or uncontrolled hypertension

Treatment Methods

01
Evaluate and treat underlying cause: antiviral therapy for hepatitis, antibiotics for infection, plasma exchange for severe cryoglobulinemia
02
Workup for complement dysregulation and monoclonal gammopathy in idiopathic cases
03
RAS blockade and blood pressure control; sodium restriction; SGLT2 inhibitor for CKD progression
04
Corticosteroids with MMF or rituximab for idiopathic MPGN with significant inflammation
05
Complement-targeted therapy (eculizumab) in selected C3 glomerulopathy cases
06
Nephrology and subspecialty care with surveillance for relapse and progression

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.