How is acute poststreptococcal glomerulonephritis (APSGN) differentiated from mesangiocapillary or membranoproliferative glomerulonephritis (MPGN)?

Updated: Dec 05, 2018
  • Author: Rajendra Bhimma, MBChB, MD, PhD, DCH (SA), FCP(Paeds)(SA), MMed(Natal); Chief Editor: Craig B Langman, MD  more...
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Answer

MPGN

Mesangiocapillary or membranoproliferative glomerulonephritis (MPGN) may have a presentation that is virtually identical to that of poststreptococcal acute glomerulonephritis. The initial manifestations are often more serious in persons with MPGN than in those with IgA nephropathy; the renal function is reduced markedly (ie, large elevation of serum creatinine).

Evidence of preexisting streptococcal infection is absent, although cases of MPGN have been reported in which clear evidence of such an infection is present. In most cases, C3 levels are depressed persistently, longer than 6 weeks.

Urinary abnormalities persist past the time of expected resolution for acute poststreptococcal glomerulonephritis.


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