Membranoproliferative Glomerulonephritis (MPGN) AKA: Mesangiocapillary GN

 • Active Urine Sediment (dysmorphic RBC, RBC casts, +/- proteinuria)

   - Mesangial hypercelluIarity

   - Endocapillary proliferation

 • Double contour formation along glomerular capillary walls

Immune-Complex Mediated

 • "Full house" IF staining (lg + complement)

 • Ex: HCV, HBV, Sjogren's, rheumatoid arthritis, monoclonal gammopathy

Complement-Mediated MGPN

 • Complement deposition without lg on IF

 • Dysregulation and activation of alternative complement pathway

 • C3 glomerulopathy (Dense deposit disease, C3GN, CFHR5 neph)

MPGN without complement of lg deposition

 • Minimal immune deposits on EM, negative IF

 • Ex: Thrombotic microangiopathy (TMA), anti-phospholipid syndrome, post-bone marrow transplantation, transplant glomerulopathy, radiation nephritis, malignant HTN



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