Manifestations of Complement-Mediated and Immune Complex-Mediated Membranoproliferative Glomerulonephritis. A Comparative Consecutive Series

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Abstract

Purpose: Membranoproliferative glomerulonephritis (MPGN) recently was reclassified to reflect the underlying cause as a complement-mediated and immune complex-mediated disease. This classification is based on renal biopsy immunofluorescence examination, making the former electron-microscopy classification obsolete. In this report, we describe related eye findings in patients with MPGN based on the new classification. Design: Retrospective case series. Participants: All Mayo Clinic Rochester patients with pathology-confirmed complement- and immune complex-mediated MPGN who had available ophthalmology records from 1997 through 2014 were included in this study. Methods: The medical and pathologic records of patients with MPGN and eye examination results were reviewed from years 1997 through 2014. Main Outcome Measures: The number of patients and the number of eyes with MPGN-related pathologic features were examined. Visual acuity also was considered. Results: There were 23 patients with complement-mediated MPGN and available eye examination results. Of these, 9 patients (39%) and 17 eyes (37%) had retinal pathologic features that likely were related to the same underlying pathophysiologic process as their renal disease. Five patients (22%) and 6 eyes (13%) had significant vision loss. There were 23 patients with immune complex-mediated MPGN and available eye examination results. Only 2 (9%) of these patients (4 eyes) had retinal pathologic features that potentially could be related to the same underlying pathophysiologic process as their renal disease, and neither had vision loss. Conclusions: Retinal abnormalities are more prominent among patients with complement-mediated MPGN when compared with patients with immune complex-mediated MPGN. It is critical for ophthalmologists to recognize the updated MPGN classification system, and all patients with complement-mediated MPGN require screening eye examinations.

Original languageEnglish (US)
JournalOphthalmology
DOIs
StateAccepted/In press - Dec 8 2015

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Membranoproliferative Glomerulonephritis
Antigen-Antibody Complex
Kidney
Immune Complex Diseases
Ophthalmology
Visual Acuity
Medical Records
Fluorescent Antibody Technique
Electron Microscopy

ASJC Scopus subject areas

  • Ophthalmology

Cite this

@article{4d2406cf24614f5a812a7f516a524ad5,
title = "Manifestations of Complement-Mediated and Immune Complex-Mediated Membranoproliferative Glomerulonephritis. A Comparative Consecutive Series",
abstract = "Purpose: Membranoproliferative glomerulonephritis (MPGN) recently was reclassified to reflect the underlying cause as a complement-mediated and immune complex-mediated disease. This classification is based on renal biopsy immunofluorescence examination, making the former electron-microscopy classification obsolete. In this report, we describe related eye findings in patients with MPGN based on the new classification. Design: Retrospective case series. Participants: All Mayo Clinic Rochester patients with pathology-confirmed complement- and immune complex-mediated MPGN who had available ophthalmology records from 1997 through 2014 were included in this study. Methods: The medical and pathologic records of patients with MPGN and eye examination results were reviewed from years 1997 through 2014. Main Outcome Measures: The number of patients and the number of eyes with MPGN-related pathologic features were examined. Visual acuity also was considered. Results: There were 23 patients with complement-mediated MPGN and available eye examination results. Of these, 9 patients (39{\%}) and 17 eyes (37{\%}) had retinal pathologic features that likely were related to the same underlying pathophysiologic process as their renal disease. Five patients (22{\%}) and 6 eyes (13{\%}) had significant vision loss. There were 23 patients with immune complex-mediated MPGN and available eye examination results. Only 2 (9{\%}) of these patients (4 eyes) had retinal pathologic features that potentially could be related to the same underlying pathophysiologic process as their renal disease, and neither had vision loss. Conclusions: Retinal abnormalities are more prominent among patients with complement-mediated MPGN when compared with patients with immune complex-mediated MPGN. It is critical for ophthalmologists to recognize the updated MPGN classification system, and all patients with complement-mediated MPGN require screening eye examinations.",
author = "Dalvin, {Lauren A.} and Fervenza, {Fernando Custodio} and Sethi, {Sanjeev M} and Pulido, {Jose S}",
year = "2015",
month = "12",
day = "8",
doi = "10.1016/j.ophtha.2016.02.018",
language = "English (US)",
journal = "Ophthalmology",
issn = "0161-6420",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Manifestations of Complement-Mediated and Immune Complex-Mediated Membranoproliferative Glomerulonephritis. A Comparative Consecutive Series

AU - Dalvin, Lauren A.

AU - Fervenza, Fernando Custodio

AU - Sethi, Sanjeev M

AU - Pulido, Jose S

PY - 2015/12/8

Y1 - 2015/12/8

N2 - Purpose: Membranoproliferative glomerulonephritis (MPGN) recently was reclassified to reflect the underlying cause as a complement-mediated and immune complex-mediated disease. This classification is based on renal biopsy immunofluorescence examination, making the former electron-microscopy classification obsolete. In this report, we describe related eye findings in patients with MPGN based on the new classification. Design: Retrospective case series. Participants: All Mayo Clinic Rochester patients with pathology-confirmed complement- and immune complex-mediated MPGN who had available ophthalmology records from 1997 through 2014 were included in this study. Methods: The medical and pathologic records of patients with MPGN and eye examination results were reviewed from years 1997 through 2014. Main Outcome Measures: The number of patients and the number of eyes with MPGN-related pathologic features were examined. Visual acuity also was considered. Results: There were 23 patients with complement-mediated MPGN and available eye examination results. Of these, 9 patients (39%) and 17 eyes (37%) had retinal pathologic features that likely were related to the same underlying pathophysiologic process as their renal disease. Five patients (22%) and 6 eyes (13%) had significant vision loss. There were 23 patients with immune complex-mediated MPGN and available eye examination results. Only 2 (9%) of these patients (4 eyes) had retinal pathologic features that potentially could be related to the same underlying pathophysiologic process as their renal disease, and neither had vision loss. Conclusions: Retinal abnormalities are more prominent among patients with complement-mediated MPGN when compared with patients with immune complex-mediated MPGN. It is critical for ophthalmologists to recognize the updated MPGN classification system, and all patients with complement-mediated MPGN require screening eye examinations.

AB - Purpose: Membranoproliferative glomerulonephritis (MPGN) recently was reclassified to reflect the underlying cause as a complement-mediated and immune complex-mediated disease. This classification is based on renal biopsy immunofluorescence examination, making the former electron-microscopy classification obsolete. In this report, we describe related eye findings in patients with MPGN based on the new classification. Design: Retrospective case series. Participants: All Mayo Clinic Rochester patients with pathology-confirmed complement- and immune complex-mediated MPGN who had available ophthalmology records from 1997 through 2014 were included in this study. Methods: The medical and pathologic records of patients with MPGN and eye examination results were reviewed from years 1997 through 2014. Main Outcome Measures: The number of patients and the number of eyes with MPGN-related pathologic features were examined. Visual acuity also was considered. Results: There were 23 patients with complement-mediated MPGN and available eye examination results. Of these, 9 patients (39%) and 17 eyes (37%) had retinal pathologic features that likely were related to the same underlying pathophysiologic process as their renal disease. Five patients (22%) and 6 eyes (13%) had significant vision loss. There were 23 patients with immune complex-mediated MPGN and available eye examination results. Only 2 (9%) of these patients (4 eyes) had retinal pathologic features that potentially could be related to the same underlying pathophysiologic process as their renal disease, and neither had vision loss. Conclusions: Retinal abnormalities are more prominent among patients with complement-mediated MPGN when compared with patients with immune complex-mediated MPGN. It is critical for ophthalmologists to recognize the updated MPGN classification system, and all patients with complement-mediated MPGN require screening eye examinations.

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U2 - 10.1016/j.ophtha.2016.02.018

DO - 10.1016/j.ophtha.2016.02.018

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JO - Ophthalmology

JF - Ophthalmology

SN - 0161-6420

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