[Extramembranous glomerulonephritis: clinicopathologic finding in a group of 45 Cameroonians]

Forty five Cameroonian patients in West Africa who were diagnosed as having membranous glomerulonephritis (MGN) were studied and followed up over a five year period. The mean age of these patients was 32.3 years with a female to male ratio of 5/4. Proteinuria (93.3%) and nephrotic syndrome (89%) were the two most important clinical manifestations at the time of diagnosis. Seventeen cases (37.8%) of the MGN were considered idiopathic while 62.2% were associated with known aetiological factors. Histologically, the majority of patients were at stage I (35.55%) or stage II (37.8%) of the World Health Organisation (WHO) classification. Except of the patients in stage I, most patients in stage II and all those in stages III and IV, showed associated important, tubular interstitial and vascular lesions. Immunofluorescence studies showed deposits to be mainly IgG (80%) and C3 (71.1%) while electron microscopy showed varied dense deposits in all cases. Seventeen patients with idiopathic MGN and 10 MGN patients whose only associates aetiological factor was a positive hepatis B antigen were followed up over 5 years. During this period, eight patients (29.6%) had a complete clinical remission, eleven patients (40.7%) improved their renal function and decreased their 24 hour proteinuria, while eight (29.6%) patients deteriorated into end stage renal failure and had to be commenced on dialysis; three of them died during this procedure.