Mesangiocapillary glomerulonephritis: diagnosis and treatment
Mesangiocapillary glomerulonephritis is called lobular - it can be met not very often, but it affects the disease, both adults and children. As for the prognosis of the disease, this species can be considered the most unfavorable. The idiopathic form is manifested in a person between the ages of 8 and 30 years.
Clinical characteristics differ depending on the severity of the pathology: usually this is a urinary syndrome with insignificant proteinuria and an admixture of blood in the urine or acute nephrotic syndrome - puffiness, hematuria, severe proteinuria, often accompanied by the formation of kidney failure.
There are three types of mesangiocapillary nephritis. According to clinical signs, they are identical, but differ slightly in their laboratory parameters and results of transplantation. Basically, patients are diagnosed with the first and second types.
Causes of development of pathology
The causes of mesangiocapillary glomerulonephritis are bacterial or viral infections.
There are cases when the damage to the body was correlated with streptococcal infections, endocarditis of the infectious form, as well as cases of manifestation of this pathology in malaria or pulmonary tuberculosis.
Also, in the emergence of mesangiocapillary glomerulonephritis, a certain role belongs to hereditary factors.
The disease affects the male body more often at a young age, as well as the children's body, and therefore, the disease is rarely diagnosed in the elderly.
Manifestations of the disease
Symptomatic of this pathology does not differ with the development of different morphological variants of the disease.
Mesangiocapillary glomerulonephritis is characterized by hematuria, severe proteinuria and nephrotic syndrome, often in acute course, as well as impaired renal function.
In 10% of cases in adults and in 5% of cases in children, mesangiocapillary glomerulonephritis becomes the cause of nephrotic syndrome. There is often a persistent increase in blood pressure. The combination of such signs as nephrotic syndrome, hematuria and high blood pressure should alert the doctor with regard to the diagnosis of mesangiocapillary glomerulonephritis. Anemia can also develop, correlated with the presence of active complement on erythrocytes.
In the development of type 2 pathology, a symmetrical lesion of the reticular membrane in a non-inflammatory eyeball having a yellow tinge is often observed.
Often, the course of mesangiocapillary glomerulonephritis begins with the development of acute nephrotic syndrome with an unexpected manifestation of hematuria, severe proteinuria, edema and increased blood pressure. Sometimes doctors in this situation mistakenly diagnose the acute form of jade. In one third of all patients, pathology is manifested by rapidly developing kidney failure.
Almost always, mesangiocapillary glomerulonephritis combines with the course of systemic pathology or infection, so a thorough search for the concomitant disease will be required for each case. Pathology is constantly progressing and only occasionally it is possible to achieve spontaneous remission.
Mesangiocapillary glomerulonephritis is considered to be the most unfavorable form, in the absence of necessary treatment, kidney failure occurs after 10 years in 50% of cases, and after 20 years - in 90% of cases of the disease.
As a characteristic feature of this pathology, its gradual progression and a sharp deterioration in kidney function in individual patients can be distinguished.
The process of treatment of the pathology of
The process of treatment of the disease is still not effective enough and unfinished. The most unfavorable signs for the prediction are the disruption of the kidneys, and the detection of nephrotic syndrome from the very onset of the disease.
There is always a risk of developing a secondary form of mesangiocapillary glomerulonephritis, which requires therapeutic treatment. With such manifestations, patients are prescribed antibacterial therapy, chemotherapy and plasmaphoresis.
Patients with mild proteinuria do not need active treatment. With an increase in blood pressure requires strict monitoring by the specialist and the taking of special medications. In severe proteinuria, cytostatic and prednisolone therapy is usually used, or a combination of medications such as dipyridamole and aspirin.
At the first signs of nephrotic syndrome and the preservation of normal kidney function, treatment begins with the administration of corticosteroids. With such therapy, the results of treatment are better in those patients who have been treated with steroid preparations for a long time.
In recent years, doctors, when a nephrotic syndrome is detected and the kidney function worsens at the outset of the disease, are more likely to prefer treatment with an immunosuppressive effect on the body. For adults, monotherapy with corticosteroids is not as effective in comparison with children, so it is used only at the first exacerbation of the nephrotic syndrome, with normal kidney function and no increase in blood pressure.