International Course on Native and Transplant Renal Biopsy Interpretation Nika Kojc Institute of Pathology, Faculty of Medicine, Ljubljana, Slovenia June 5th 2014 Membranoprolifera-ve     glomerulonephri-s   •  A  lesion  or  a  disease   •  Pa7ern  of  glomerular  injury   •  Classifica-on:  based  on  histologic  and   ultrastructural  features   •  Heterogeneity  of  e-opathogene-c   mechanisms MPGN  classifica-on   Histomorphologic  pa7ern  +  loca-on  of  deposits   –  MPGN  type  I   –  MPGN  type  II     –  MPGN  type  III   •  Burkholder  variant   •  Anders  and  Strife  variant   Loca-on  of  deposits  does  not  reflect   ethiopatogene-c  mechanisms  leading  to  MPGN. MPGN  type  I MPGN typ III Burkholder MPGN  type  III  A  &  S   MPGN     MPGN  -p  III   MPGN  -p  I Imunofluorescence   •  Deposits  of  immunoglobulins    IgG  in/ali  IgM,   IgA   •  Deposits  of  complement  components  C3  and/ or  C1   •  Dominant  C3  deposits? Dense  deposit   disease   Galle  (1962):     • new  glomerular  disease   en-ty     • electron  dense   transforma-on  of  GBM   Paris.  Medical  school,  University   of    Paris;  1962   Habib  et  al.  (1975):     • Dense  deposit  disease:  a   variant  of  MPGN.   Kidney  Int,  7;   204–215,  1975