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Segmental membranous nephropathy

Hae Yoon Grace Choung1, Bruce Goldman2

  • 1Department of Pathology and Laboratory Medicine, Division of Renal Pathology and Electron Microscopy Laboratory, University of Rochester Medical Center, 601 Elmwood Ave, Box 626, Rochester, NY, 14642, USA. haeyoon_choung@urmc.rochester.edu.

Clinical and Experimental Nephrology
|March 23, 2021
PubMed

Insights

Segmental membranous nephropathy (MGN) presents focal deposits, unlike typical diffuse MGN. Its significance is unclear, possibly indicating early/resolving disease or secondary causes, impacting renal biopsy interpretation.

Area of Science:

  • Nephrology
  • Pathology
  • Immunology

Background:

  • Membranous nephropathy (MGN) typically shows global subepithelial deposits.
  • Segmental MGN, with focal segmental deposits, is less common and its significance is debated.
  • It may represent an early or resolving phase of primary MGN or a manifestation of secondary causes.

Purpose of the Study:

  • To review and integrate current knowledge on segmental MGN.
  • To aid in the interpretation of renal biopsies showing segmental MGN.
  • To clarify the clinical and pathological significance of segmental MGN.

Main Methods:

  • Literature review and synthesis of case reports and existing studies on segmental MGN.
  • Analysis of pathological features associated with segmental MGN, including immune deposits and subclass dominance.
  • Integration of clinical and pathological data to differentiate primary vs. secondary causes.

Main Results:

  • Segmental MGN may be associated with secondary causes, indicated by C1q and mesangial deposits, extra-glomerular deposits, absence of PLA2R/THSD7A, and IgG1/IgG3 dominance.
  • Some cases might represent a variant of primary MGN.
  • Pathological features are key to distinguishing potential etiologies.

Conclusions:

  • Segmental MGN's interpretation requires careful consideration of specific pathological findings.
  • Distinguishing between primary and secondary causes is crucial for patient management.
  • Further research is needed to fully elucidate the clinical significance of segmental MGN.
Keywords:
Immune complex renal diseaseMembranous nephropathyNephrotic syndromeSegmental membranous nephropathy

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