Hohenstein Bernd
Dtsch Med Wochenschr. 2020 Feb;145(4):232-239. doi: 10.1055/a-0974-8418. Epub 2020 Feb 18.
Membranoproliferative glomerulonephritis (MPGN) and glomerulopathy with dominant C3 deposits are very rare autoimmune disorders of the kidney that had been classified in its current form in 2010 due to a better understanding of the underlying pathophysiology.Today, the immune complex-associated membranoproliferative glomerulonephritis (IC-MPGN) and C3 glomerulopathy (C3G) represent a disease spectrum which is heterogeneous in terms of pathophysiology and the clinical time course. Interestingly, recent research demonstrated more common pathophysiological aspects with respect to secondary causes, autoantibodies, and genetics of IC-MPGN and C3G than it had been suggested with the creation of the 2010 classification.This knowledge of the underlying pathophysiology is of specific importance for the identification of potential secondary causes. Therefore, following histologic diagnosis a comprehensive complement analysis, accompanied by antibody screening and human genetics should be carried out consistently. The published evidence provides a robust basis for the use of available therapeutic approaches for these often rapidly progressive and relapsing diseases.
膜增生性肾小球肾炎(MPGN)和以C3沉积为主的肾小球病是非常罕见的肾脏自身免疫性疾病,由于对其潜在病理生理学有了更好的理解,于2010年以目前的形式进行了分类。如今,免疫复合物相关的膜增生性肾小球肾炎(IC-MPGN)和C3肾小球病(C3G)代表了一个在病理生理学和临床病程方面具有异质性的疾病谱。有趣的是,最近的研究表明,IC-MPGN和C3G在继发原因、自身抗体和遗传学方面的病理生理方面比2010年分类创建时所表明的更为常见。这种对潜在病理生理学的认识对于识别潜在的继发原因具有特别重要的意义。因此,在组织学诊断后,应始终如一地进行全面的补体分析,并伴有抗体筛查和人类遗传学检测。已发表的证据为使用针对这些通常快速进展和复发疾病的现有治疗方法提供了有力依据。