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Old 07-28-2011
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Default confusion about type 1 MPGN!

hey guys, in fa it said that type 1 membranous proliferative glomerulonephropathy is more common in HBV than in HCV.
Goljan says type 1 MPGN is more common in HCV than HBV
confused!!!
does anyone of you know the correct answer?
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Old 07-28-2011
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Hepatitis C (with or without cryoglobulinemia) = MC Type I MGPN
Hepatitis B = MC membranous glomerulopathy

Ref: Primer on Kidney Diseases (Greenberg, Primer on Kidney) by Arthur Greenberg

--------------------
Type I MGPN often is secondary to recognizable causes, such as cryoglobulinemia, hepatitis C, hepatitis B, osteomyelitis, subacute bacterial endocarditis, or infected ventriculoatrial shunt. Serologic and clinical evidence of these processes should be sought. The observation that upper respiratory tract infections precede the onset of what is considered idiopathic MPGN in as many as one half of patients raises the possibility that infectious agents contribute to the pathogenesis of many examples of idiopathic type I MPGN.

Some proportion of type I MPGN is attributable to hepatitis C with or without cryoglobulinemia. The precise percentage of patients with MPGN due to hepatitis C may vary according to geographic area and cultural factors. Consequently, the overall percentage of patients with MPGN type I with hepatitis C across the globe is still unknown. When MPGN is secondary to other disease processes such as malignancy or a rheumatic condition, the laboratory features associated with the systemic disease (for instance SLE) are positive (e.g., antibodies to double-stranded DNA).

Secondary membranous glomerulopathy, especially that caused by hepatitis B and lupus, is more frequent in children than adults. In patients over the age of 60, membranous glomerulopathy is associated with a malignancy in from 20% to 30% of patients.

ref: Brenner: Brenner and Rector's The Kidney, 8th ed. (the "bible" haha)
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