MEMBRANOUS GLOMERULOPATHY
MEMBRANOUS GLOMERULOPATHY (MGN) Most common in Geriatric population primary membranous glomerulopathy: - Antibody against Phospholipase A2 receptor (PLA2) Secondary membranous glomerulopathy: CONNECTIVE TISSUE DISORDER: RA/SLE/SCLERODERMA/MCTD AUTOIMMUNE DISORDERS LIKE HASHIMOTO THYROIDITIS/GRAVES INFECTION: ENTEROCOCCI ENDOCARDITIS/HBV/HCV/LEPROSY/MALARIA SOLID ORGAN TUMORS: LUNG CANCER DRUGS: PENICILLAMINE,CAPTOPRIL,MERCURY BASED COMPOUNDS CLINICAL FEATURES: Puffy eyes - pedal edema Anasarca Hypertension WORKUP: URINE - Oral fat bodies Blood urea nitrogen increased,serum creatinine increased Anti nuclear antibody (ANA) ++ HIV/HBV/HCV workup for malignancy(solid organ tumor) Cryoglobulin levels KIDNEY BIOPSY: - Hyper cellularity - polymorpho nuclear cells(PMN cells) - C3/ IgM/igG - Sub epithelial deposits + spikes Anti phospholipase A2 antibody +++ TREATMENT: Low protein diet Furosemide - oedema Hype...