Histological restoration in an adult with membranoproliferative glomerulonephritis

Abstract

A 26-year-old woman presented with nephrotic syndrome. Histological study showed membranoproliferative glomerulonephritis (MPGN) type 1. Aggressive treatment with steroid pulse therapy (methylprednisolone, 1 g × 3 days, followed by combination therapy with prednisolone, cyclophosphamide, warfarin, and dipyridamole) led to the resolution of the nephrotic syndrome. In a year, she achieved complete remission. Prednisolone was tapered off, but treatment with warfarin and dipyridamole was maintained. When she was 34 years old, she hoped to become pregnant and visited our hospital for a re-evaluation of her renal status. Although she had no serological or urinary abnormality, we performed a second biopsy, which revealed only a mild degree of mesangial expansion, and no electron-dense deposits. The clinical course of adult MPGN varies; however, follow-up studies including re-biopsy are rare. This histological change may have implications in regard to normolization of renal damage in adults with MPGN.