IgA dominant membranoproliferative glomerulonephritis (MPGN) is a descriptive term for renal biopsies in which differential diagnoses of unusual IgA nephropathy (IgAN), infection-related GN, monotypic IgA MPGN or other etiologies are considered.
Take home messages
Two groups (n=27, 33 biopsies) were identified (with/without chronic liver disease (CLD)
Renal biopsies from patients without CLD showed higher incidence of fibrinoid necrosis and crescents formation
Pt w/o CLD (n=15) are younger (40 yo), with no history of infection, three (27%) progressed to ESRD, one had recurrent GN in allograft, four of five patients had persistent IgA dominant MPGN
Pt w/ CLD (n=12) are older (56 yo), with concurrent infections (42%), 80% of those died in the following year and 2 were dialysis-dependent
IgA dominant MPGN has a poorer prognosis as compared to IgA nephropathy in patients without CLD and is correlated with infections in CLD patients, leading to death within one year regardless of treatment