[Membranous glomerulonephritis in children: 20 cases].

Area of Science:

• Nephrology
• Pediatric Nephrology
• Immunopathology

Context:

• Membranous glomerulonephritis (MGN) is a significant cause of nephrotic syndrome in children.
• Understanding the long-term outcomes and etiological factors in pediatric MGN is crucial for effective management.
• This study reviews a cohort of pediatric MGN cases diagnosed over a decade.

Purpose:

• To analyze the clinical presentation, histological findings, etiology, and long-term outcomes of membranous glomerulonephritis in children.
• To identify potential risk factors and prognostic indicators for disease progression in pediatric MGN.
• To evaluate the impact of D-penicillamine and HBs antigen on the development of MGN.

Summary:

• Twenty pediatric cases of MGN were analyzed, with a median follow-up of 5.1 years.
• Proteinuria and microscopic hematuria were common, with some cases progressing to nephrotic syndrome or renal failure.
• Histopathology revealed stage II MGN with significant immunoglobulin and C3 deposits. Idiopathic cases predominated (85%), with D-penicillamine and HBs antigen identified in a minority.
• While 38% of patients achieved complete remission of proteinuria, 55% had persistent proteinuria. One case progressed to end-stage renal failure.

Impact:

• Provides valuable insights into the natural history and prognosis of pediatric membranous glomerulonephritis.
• Highlights the heterogeneity of disease presentation and outcome in children with MGN.
• Informs clinical decision-making and underscores the need for further research into the pathogenesis and treatment of pediatric MGN.