Abstract
We report a case of ORN with prolonged proteinuria after pathologically improvement of membranoproliferative glomerulonephritis (MPGN) type III.
First renal biopsy (12 y.o.) revealed diffuse mesangial hypercellularity in light microscopy, and glomerular subendothelial and subepithelial deposits in electron microscopy. Immunofluorescence techniques showed IgG, C3 and IgM in a finely granular pattern along the glomerular capillaries and in the mesangial regions. She was diagnosed as MPGN, so she was treated by predonisolone, warfarin, dilazep dihydrochloride and lisinopril, leading to complete remission in 7 months.
But again she showed proteinuria at 17 y.o. so second biopsy was performed, which revealed only focal mesangial hypercellularity in light microscopy, and glomerular diameter was larger than the first one. Although there were no electron dense deposits, her BMI increased from 26.8 to 36.3. We diagnosed her as obesity-related glomerulopathy (ORN).
ORN was defined morphologically as focal segmental glomerulosclerosis and/or glomerulomegaly. Recently it is said that metabolic syndrome and obesity in children are increasing, so in future, ORN will also increase in children. In conclusion, we pediatrician have to care and know this renal disease.
