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06-05-2009, 09:30 AM
Membranous G.N.
$ It is the commonest cause of nephrotic $ in adults (MCQ).
$ If occurs in old age search for malignancy.
$ C R F can occur within 10 yrs.
$ Ch. Ch by heavy proteinuria + ­­ incidence of renal vein thrombosis

Causes: (pathogenesis most likely in situe imm. Complex)
1 ry
2 ry S.L.E. - hep. B - malaria (p. malaria) gold -
penicillamine - captoril mercury

Micro: ( thick basement membrane due to deposition of immune complex)
Light thick B. M.
E/ M more details
thick B. M. & subepith spickes


Immunofloursence. Ig G - C3

ttt : controversy
Some recommend steroids + cytotoxic drugs.
risk. The side effects of drugs
Value proteinuria.
To post pond renal failure!?
Prognosis:

50 % of pts develop renal failure, while 25 % have complete
remission.

Source: Internal Medicine Book of Dr.Osama Mahmoud (Ain Shams University)