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Regression of membranoproliferative glomerulonephritis type II (dense deposit disease): observations in six children

P T McEnery1, A J McAdams

  • 1Division of Pediatric Nephrology, Children's Hospital Medical Center, Cincinnati, OH 45229.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|August 1, 1988
PubMed

Insights

Alternate-day prednisone therapy significantly reduced mesangial proliferation and improved kidney function in children with membranoproliferative glomerulonephritis Type II (MPGN II-dense deposit disease). Dense deposits were ultrastructurally lost in some patients.

Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Glomerular Diseases

Background:

  • Membranoproliferative glomerulonephritis Type II (MPGN II), also known as dense deposit disease, is a rare kidney disorder.
  • MPGN II is characterized by abnormal deposits within the glomerular basement membrane.
  • Long-term treatment outcomes for MPGN II in children are not well-established.

Purpose of the Study:

  • To evaluate the long-term effects of alternate-day prednisone on renal histology in pediatric MPGN II patients.
  • To assess changes in mesangial proliferation and capillary lumen patency over time.
  • To investigate ultrastructural changes in glomerular deposits during treatment.

Main Methods:

  • Retrospective analysis of serial renal biopsies from six children with MPGN II.
  • Patients received continuous alternate-day prednisone therapy for an average of 14 years.
  • Histopathological and ultrastructural examination of kidney biopsies.

Main Results:

  • All patients showed reduced mesangial proliferation and improved capillary lumen patency.
  • Ultrastructural analysis revealed a shift of deposits from the lamina densa to the lamina rara interna in four patients.
  • Complete loss of dense deposits was observed in the capillary walls of two patients.

Conclusions:

  • Alternate-day prednisone therapy can lead to significant histological improvements in pediatric MPGN II.
  • The observed ultrastructural changes suggest a potential mechanism for deposit clearance.
  • Long-term prednisone treatment may be a viable therapeutic option for MPGN II in children.

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