International Course on Native and Transplant Renal Biopsy

47 Pages·2014·18.86 MB·English

International Course on Native and Transplant Renal Biopsy Interpretation
Nika Kojc
Institute of Pathology, Faculty of Medicine, Ljubljana, Slovenia
June 5th 2014
Membranoprolifera-ve

glomerulonephri-s

•  A
 lesion
 or
 a
 disease

•  Pa7ern
 of
 glomerular
 injury

•  Classifica-on:
 based
 on
 histologic
 and

ultrastructural
 features

•  Heterogeneity
 of
 e-opathogene-c

mechanisms

MPGN
 classifica-on

Histomorphologic
 pa7ern
 +
 loca-on
 of
 deposits

–  MPGN
 type
 I

–  MPGN
 type
 II

–  MPGN
 type
 III

•  Burkholder
 variant

•  Anders
 and
 Strife
 variant

Loca-on
 of
 deposits
 does
 not
 reflect

ethiopatogene-c
 mechanisms
 leading
 to
 MPGN.
MPGN
 type
 I
MPGN typ III
Burkholder
MPGN
 type
 III
 A
 &
 S

MPGN

MPGN
 -p
 III

MPGN
 -p
 I
Imunofluorescence

•  Deposits
 of
 immunoglobulins

 IgG
 in/ali
 IgM,

IgA

•  Deposits
 of
 complement
 components
 C3
 and/
or
 C1

•  Dominant
 C3
 deposits?
Dense
 deposit

disease

Galle
 (1962):

• new
 glomerular
 disease

en-ty

• electron
 dense

transforma-on
 of
 GBM

Paris.
 Medical
 school,
 University

of

 Paris;
 1962

Habib
 et
 al.
 (1975):

• Dense
 deposit
 disease:
 a

variant
 of
 MPGN.

Kidney
 Int,
 7;

204–215,
 1975