WordNet

put into a bank account; "She deposits her paycheck every month" (同)bank
money deposited in a bank or some similar institution (同)bank deposit
the phenomenon of sediment or gravel accumulating (同)sedimentation, alluviation
money given as security for an article acquired for temporary use; "his deposit was refunded when he returned the car"
the act of putting something somewhere (同)deposition
a payment given as a guarantee that an obligation will be met
having high relative density or specific gravity; "dense as lead"
slow to learn or understand; lacking intellectual acuity; "so dense he never understands anything I say to him"; "never met anyone quite so dim"; "although dull at classical learning, at mathematics he was uncommonly quick"- Thackeray; "dumb officials make some really dumb decisions"; "he was either normally stupid or being deliberately obtuse"; "worked with the slow students" (同)dim, dull, dumb, obtuse, slow
permitting little if any light to pass through because of denseness of matter; "dense smoke"; "heavy fog"; "impenetrable gloom" (同)heavy, impenetrable
hard to pass through because of dense growth; "dense vegetation"; "thick woods" (同)thick
an impairment of health or a condition of abnormal functioning
a room that is comfortable and secluded
a unit of 8 to 10 cub scouts
caused by or altered by or manifesting disease or pathology; "diseased tonsils"; "a morbid growth"; "pathologic tissue"; "pathological bodily processes" (同)morbid, pathologic, pathological

PrepTutorEJDIC

〈貴重品など〉‘を'『預ける』,〈金〉‘を'預金する / (注意深く,確実に)…‘を'置く,おろす / (自然の作用によって)〈泥・土など〉‘を'沈殿させる / (銀行への)『預金』,預け入れ / 『担保』,手付け金 / (自然の作用による)『堆積物』,沈殿物 / (特に石油・鉱石の)鉱床,埋蔵物
『密度が濃い』,密集した,目の詰まった / 《話》頭の鈍い,のろまな
(体の)『病気』,疾患 / (精神・道徳などの)病気,病弊
女性の話術芸人 =diseur
(野生動物の)巣穴,ほら穴 / 《話》奥まった小部屋;私室 / 隠れ家(が);(特に犯罪者の)根城,巣
病気にかかった / 病的な,不健全な(morbid)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/03/26 19:08:56」(JST)

wiki en

Membranoproliferative glomerulonephritis ("MPGN"), also known as mesangiocapillary glomerulonephritis,^[1] is a type of glomerulonephritis caused by deposits in the kidney glomerular mesangium and basement membrane (GBM) thickening,^[2] activating complement and damaging the glomeruli.

MPGN accounts for approximately 4% of primary renal causes of nephritic syndrome in children and 7% in adults.^[3]

It should not be confused with membranous glomerulonephritis, a condition in where the basement membrane is thickened, but the mesangium is not.

Pathology[edit]

Renal corpuscle. Membranoproliferative glomerulonephritis involves deposits at the intraglomerular mesangium (#5a) which leads to "splitting" of the glomerular basement membrane (#1).

Membranoproliferative glomerulonephritis involves deposits at the intraglomerular mesangium.

It is also the main hepatitis C associated nephropathy.

The histomorphologic differential diagnosis includes transplant glomerulopathy and thrombotic microangiopathies.

Appearance[edit]

The GBM is rebuilt on top of the deposits, causing a "tram tracking" appearance under the microscope.^[4] Mesangial cellularity is increased.^[5]

Type[edit]

There are three types of MPGN.

Type I[edit]

Type I the most common by far, is caused by immune complexes depositing in the kidney. It is characterised by subendothelial and mesangial immune deposits.

It is believed to be associated with the classical complement pathway.^[6]

Type II[edit]

Type II (sometimes also called "dense deposit disease"^[7]) is similar to type I. However, it is believed to be associated with the alternative complement pathway.^[8]^[9]

Spontaneous remissions of MPGN II are rare, approximately half of those affected with MPGN II will progress to end stage renal disease within 10 years.^[10]

In many cases, people with MPGN II can develop drusen which is caused by same deposits within the Bruch's membrane beneath the retinal pigment epithelium (RPE) layer of the eye. Over time vision can deteriorate and subretinal neovascular membranes, macular detachment, and central serous retinopathy develop.^[11]

A report in 2007 suggests that dense deposit disease may not be a membranoproliferative glomerulonephritis subtype.^[12] A 2012 review considers DDD to be in a continuum with C3 glomerulonephritis.^[13]

( See also : Eculizumab#Dense-deposit disease (DDD) )

Type III[edit]

Type III is very rare, it is characterized by a mixture of subepithelial deposits and the typical pathological findings of Type I disease.

A candidate gene has been identified on chromosome 1.^[14]

Complement component 3 is seen under immunofluorescence.^[15]

References[edit]

^ Colville D, Guymer R, Sinclair RA, Savige J (August 2003). "Visual impairment caused by retinal abnormalities in mesangiocapillary (membranoproliferative) glomerulonephritis type II ("dense deposit disease")". Am. J. Kidney Dis. 42 (2): E2–5. doi:10.1016/S0272-6386(03)00665-6. PMID 12900843.
^ "membranoproliferative glomerulonephritis" at Dorland's Medical Dictionary
^ Habib R, Gubler MC, Loirat C, Mäiz HB, Levy M (1975). "Dense deposit disease: a variant of membranoproliferative glomerulonephritis". Kidney Int. 7 (4): 204–15. doi:10.1038/ki.1975.32. PMID 1095806.
^ "Membranoproliferative_glomerulonephritis_type_I of the Kidney". Retrieved 2008-11-25.
^ "Renal Pathology". Retrieved 2008-11-25.
^ West CD, McAdams AJ (March 1998). "Glomerular paramesangial deposits: association with hypocomplementemia in membranoproliferative glomerulonephritis types I and III". Am. J. Kidney Dis. 31 (3): 427–34. doi:10.1053/ajkd.1998.v31.pm9506679. PMID 9506679.
^ "Final Diagnosis — Case 148". Retrieved 2008-11-25.
^ Rose KL, Paixao-Cavalcante D, Fish J, et al. (February 2008). "Factor I is required for the development of membranoproliferative glomerulonephritis in factor H-deficient mice". J. Clin. Invest. 118 (2): 608–18. doi:10.1172/JCI32525. PMC 2200299. PMID 18202746.
^ Licht C, Schlötzer-Schrehardt U, Kirschfink M, Zipfel PF, Hoppe B (January 2007). "MPGN II--genetically determined by defective complement regulation?". Pediatr. Nephrol. 22 (1): 2–9. doi:10.1007/s00467-006-0299-8. PMID 17024390.
^ Swainson CP, Robson JS, Thomson D, MacDonald MK (1983). "Mesangiocapillary glomerulonephritis: a long-term study of 40 cases". J. Pathol. 141 (4): 449–68. doi:10.1002/path.1711410404. PMID 6363655.
^ Colville D, Guymer R, Sinclair RA, Savige J (2003). "Visual impairment caused by retinal abnormalities in mesangiocapillary (membranoproliferative) glomerulonephritis type II ("dense deposit disease")". Am. J. Kidney Dis. 42 (2): E2–5. doi:10.1016/S0272-6386(03)00665-6. PMID 12900843.
^ Patrick D Walker, Franco Ferrario, Kensuke Joh, Stephen M Bonsib (2007). "Dense deposit disease is not a membranoproliferative glomerulonephritis". Modern Pathology. 20 (6): 605–616. doi:10.1038/modpathol.3800773. PMID 17396142
^ Sethi, Fervenza, S, FC (2012). "Membranoproliferative glomerulonephritis - a new look at an old entity". N Engl J Med 366: 1119–1131. doi:10.1056/NEJMra1108178.
^ Neary JJ, Conlon PJ, Croke D, et al. (August 2002). "Linkage of a gene causing familial membranoproliferative glomerulonephritis type III to chromosome 1". J. Am. Soc. Nephrol. 13 (8): 2052–7. doi:10.1097/01.ASN.0000022006.49966.F8. PMID 12138136.
^ Neary J, Dorman A, Campbell E, Keogan M, Conlon P (July 2002). "Familial membranoproliferative glomerulonephritis type III". Am. J. Kidney Dis. 40 (1): E1. doi:10.1053/ajkd.2002.33932. PMID 12087587.

External links[edit]

Glomerulonephritis, Membranoproliferative Types I,II,III at eMedicine
Corchado, Johnny Cruz; Smith, Richard JH (July 2007). "Dense Deposit Disease/Membranoproliferative Glomerulonephritis Type II". In Pagon RA, Bird TD, Dolan CR, et al.. GeneReviews. Seattle WA: University of Washington. PMID 20301598.
Membranoproliferative_GN at Nephropathology tutorial
MP GN Pathophysiology discusses the nephritic auto-antibodies/factors

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. C3糸球体腎症：デンスデポジット病およびC3糸球体腎炎 c3 glomerulopathies dense deposit disease and c3 glomerulonephritis
2. 膜性増殖性糸球体腎炎の臨床像、分類、および原因 clinical presentation classification and causes of membranoproliferative glomerulonephritis
3. 補体系の後天性欠損 acquired deficiencies of the complement system
4. 移植後の免疫複合体媒介性の特発性膜性増殖性糸球体腎炎（MPGN）再発 recurrence of idiopathic immune complex mediated membranoproliferative glomerulonephritis mpgn after transplantation
5. C4糸球体症 c4 glomerulopathy

English Journal

Origin of a false positive urine pregnancy test in a patient with membranoproliferative glomerulonephritis type I.

Marzinke MA, Jarrar P, Atkinson M, Humphrey RL, Detrick B, Sokoll LJ.SourceDepartment of Pathology, Johns Hopkins Medical Institutions, 600 N. Wolfe St., Baltimore, MD 21287, United States.
Clinica chimica acta; international journal of clinical chemistry.Clin Chim Acta.2012 Jan 18;413(1-2):361-3. Epub 2011 Oct 15.
BACKGROUND: Discrepant qualitative urine and quantitative serum hCG results were observed in a patient with a history of membranoproliferative glomerulonephritis. Further studies were performed to investigate this discrepancy.METHODS: Urine and serum specimens were analyzed using alternate methods a
PMID 22024216

Imatinib Therapy for Non-Infection-Related Type II Cryoglobulinemia With Membranoproliferative Glomerulonephritis.

Wallace E, Fogo AB, Schulman G.SourceDivision of Nephrology, Vanderbilt University, Nashville, TN.
American journal of kidney diseases : the official journal of the National Kidney Foundation.Am J Kidney Dis.2012 Jan;59(1):122-5. Epub 2011 Oct 7.
Cryoglobulinemia is a systemic immune complex-mediated vasculitis that can have significant morbidity and mortality. The current treatment for cryoglobulinemia, including chlorambucil, steroids, plasmapheresis, and rituximab, is lacking in terms of efficacy, safety, and relapse rates. Imatinib, a ty
PMID 21982457

Japanese Journal

＜Poster＞Cellular and subcellular localizations of nonheme ferric and ferrous iron in the rat brain : a light and electron microscopic study by the perfusion-Perls and -Turnbull methods

Meguro Reiko,Asano Yoshiya,Odagiri Saori,Li Chengtai,Shoumura Kazuhiko,Ichinohe Noritaka
弘前醫學 61(Supplement), S245-S251, 2010
… Amongthe cellular elements of the brain, oligodendrocytes were numerically most prominent and heavily iron-storing cells.Pericapillary astrocytes and sporadic microglial cells also showed dense iron accumulation. … Fe（II）-specific deposit was shown on the luminalmembrane of endothelium. …
NAID 110007617492

Related Pictures

★リンクテーブル★

リンク元	「膜性増殖性糸球体腎炎」「デンス・デポジット病」「デンスデポジット病」
関連記事	「disease」「deposit」「dense」

「膜性増殖性糸球体腎炎」

Membranoproliferative glomerulonephritis
	Classification and external resources
	; Micrograph of glomerulus in membranoproliferative glomerulonephritis with increased mesangial matrix and increased mesangial cellularity. Kidney biopsy. PAS stain.
ICD-10	N00-N08 with .5 and .6 suffix
ICD-9	581.2, 582.2, 583.2
OMIM	609814 305800
DiseasesDB	34457
MedlinePlus	000475
eMedicine	med/887
MeSH	D015432
GeneReviews	Dense Deposit Disease/Membranoproliferative Glomerulonephritis Type II;

　　[★]

英: membranoproliferative glomerulonephritis, MPGN
同: メサンギウム毛細管性糸球体腎炎 mesangiocapillary glomerulonephritis MCGN
関: 糸球体腎炎、糸球体疾患

概念

糸球体腎炎の病理診断名の一つ。
光顕的に(1)メサンギウム細胞・メサンギウム基質の増殖、(2)びまん性の糸球体基底膜の二重化　→　糸球体基底膜上皮細胞の障害と糸球体の炎症を兼ね備える。
しかも原発性であること。

分類

WHO分類

電顕所見よる高電子密度沈着物の部位で分類

I型：内皮下腔

全周性のメサンギウム間入とメサンギウム領域、内皮細胞下腔の高電子密度沈着物がみられる

II型：糸球体基底膜内
III型：内皮細胞下腔と上皮細胞下腔の両方

頻度

ネフローゼ症候群

膜性増殖性糸球体腎炎が原因となって生じるネフローゼ症候群の小児10%、成人5%を占める。

病因

50%の症例に先行感染が見られるという、、、
何らかの原因がきっかけで補体(C3やC4)が関与することになり、病変を形成　→　50～70%が低補体血症を示す。

病因による分類

特発性
二次性

I型　　：細菌性心内膜炎、B型肝炎ウイルス(成人)、C型肝炎ウイルス(±クリオグロブリン血症)、クリオグロブリン血症、マラリア、シャント腎炎
II型　：partial lipodystrophy
III型：ループス腎炎

沈着物

I,III型：免疫複合体、C3、C4
II型　：C3　←　免疫複合体ではない。　→　移植腎に再発するため血液中の未知物質が原因

II型はI,III型とことなり、デンスデポジット病(dense deposit disease)と呼ばれる。

補体の活性経路

I, III型：C3,C4,IC　　　　　　　：classical pathway
II型　　：C3 nephritic factor：alternative pathway

症状

血尿(肉眼的血尿, 1/3の症例)・蛋白尿、腎機能低下(糸球体濾過量の低下)(1/3の症例)、高血圧(1/3の症例)
糸球体腎炎＋ネフローゼ症候群がみられる

チャンス蛋白尿やチャンス血尿で発見される(らしい・・・)

ネフローゼ症候群(50%の症例)
急性糸球体腎炎(20%の症例)

検査

尿検査

血尿、蛋白尿、赤血球円柱、顆粒円柱

免疫血清学

低補体血症　→　症例の70%

I型：CH50, C3, C4, C1q　の低下
II型：C3, CH50の持続低下(75％の症例)

病理所見

[show details]

光顕所見

びまん性メザンギウム細胞およびメザンギウム細胞基質の増加
分葉化
糸球体毛細血管係蹄腔の狭小化
基底膜の二重化(double contour)、tram track

蛍光所見

IgG、C3が係蹄壁にfringe pattern

電顕所見

I型　　：内皮下沈着物　←　糸球体の内側
II型　：(Dense Deposit Disease)基底膜の緻密層(lamina densa)にリボン状の広範な沈着物　←　基底膜の真ん中
III型：内皮下、上皮下、基底膜内に沈着物

治療

治療は、副腎皮質ステロイド薬、免疫抑制薬、抗血小板薬、抗凝固薬などを併用する。　→　多剤併用(カクテル)療法、時にステロイドパルス療法が有効

予後

進行性で予後は不良
10年後に50%が腎不全に進行(10年腎生存率50-60%)
予後不良例：「硬化病変の高度なもの」、「半月体・尿細管－間質病変が高度なもの。」
I型よりII型は予後不良。II型は半月体形成する。　←　予後が悪いことを裏付け。　
II型は移植腎に再発(ほぼ100%)

国試

103A042

「デンス・デポジット病」

　　[★]

英: dense deposit disease DDD
同: デンス・デポジット糸球体腎炎 dense deposit glomerulonephritis、膜性増殖性糸球体腎炎II型 membranoproliferative glomerulonephritis type II

「デンスデポジット病」

　　[★]

英: dense deposit disease
関: 膜性増殖性糸球体腎炎、メサンギウム毛細血管性糸球体腎炎

「disease」

　　[★]

n.

疾患：illnessより厳密な概念。「ある臓器に明確な障害が確認され、それによって症状が出ているとはっきり説明できる場合」 (PSY.9)

特定の原因、病態生理、症状、経過、予後、病理組織所見が全てそろった場合 (PSY.9)

something that is very wrong with people's attitudes, way of life or with society.

関: ail、ailment、disease entity、disorder、ill、illness、malady、sick、sickness

注意

disease ≠ illness ≠ disorder

「deposit」

　　[★]

沈着物、沈着、蓄積、沈着する、析出する、堆積する、預ける

関: accumulate、accumulation、bank、deposition、reservoir

「dense」

　　[★]

adj.

(比較級denser-最上級densest)密な、高密度な、濃い

関: dark、densely、high density、thick

[pmid12900843-1] Colville D, Guymer R, Sinclair RA, Savige J (August 2003). "Visual impairment caused by retinal abnormalities in mesangiocapillary (membranoproliferative) glomerulonephritis type II ("dense deposit disease")". Am. J. Kidney Dis. 42 (2): E2–5. doi:10.1016/S0272-6386(03)00665-6. PMID 12900843.

[2] "membranoproliferative glomerulonephritis" at Dorland's Medical Dictionary

[3] Habib R, Gubler MC, Loirat C, Mäiz HB, Levy M (1975). "Dense deposit disease: a variant of membranoproliferative glomerulonephritis". Kidney Int. 7 (4): 204–15. doi:10.1038/ki.1975.32. PMID 1095806.

[4] "Membranoproliferative_glomerulonephritis_type_I of the Kidney". Retrieved 2008-11-25.

[5] "Renal Pathology". Retrieved 2008-11-25.

[pmid9506679-6] West CD, McAdams AJ (March 1998). "Glomerular paramesangial deposits: association with hypocomplementemia in membranoproliferative glomerulonephritis types I and III". Am. J. Kidney Dis. 31 (3): 427–34. doi:10.1053/ajkd.1998.v31.pm9506679. PMID 9506679.

[urlFinal_Diagnosis_--_Case_148-7] "Final Diagnosis — Case 148". Retrieved 2008-11-25.

[pmid18202746-8] Rose KL, Paixao-Cavalcante D, Fish J, et al. (February 2008). "Factor I is required for the development of membranoproliferative glomerulonephritis in factor H-deficient mice". J. Clin. Invest. 118 (2): 608–18. doi:10.1172/JCI32525. PMC 2200299. PMID 18202746.

[pmid17024390-9] Licht C, Schlötzer-Schrehardt U, Kirschfink M, Zipfel PF, Hoppe B (January 2007). "MPGN II--genetically determined by defective complement regulation?". Pediatr. Nephrol. 22 (1): 2–9. doi:10.1007/s00467-006-0299-8. PMID 17024390.

[10] Swainson CP, Robson JS, Thomson D, MacDonald MK (1983). "Mesangiocapillary glomerulonephritis: a long-term study of 40 cases". J. Pathol. 141 (4): 449–68. doi:10.1002/path.1711410404. PMID 6363655.

[11] Colville D, Guymer R, Sinclair RA, Savige J (2003). "Visual impairment caused by retinal abnormalities in mesangiocapillary (membranoproliferative) glomerulonephritis type II ("dense deposit disease")". Am. J. Kidney Dis. 42 (2): E2–5. doi:10.1016/S0272-6386(03)00665-6. PMID 12900843.

[12] Patrick D Walker, Franco Ferrario, Kensuke Joh, Stephen M Bonsib (2007). "Dense deposit disease is not a membranoproliferative glomerulonephritis". Modern Pathology. 20 (6): 605–616. doi:10.1038/modpathol.3800773. PMID 17396142

[Sethi2012-13] Sethi, Fervenza, S, FC (2012). "Membranoproliferative glomerulonephritis - a new look at an old entity". N Engl J Med 366: 1119–1131. doi:10.1056/NEJMra1108178.

[pmid12138136-14] Neary JJ, Conlon PJ, Croke D, et al. (August 2002). "Linkage of a gene causing familial membranoproliferative glomerulonephritis type III to chromosome 1". J. Am. Soc. Nephrol. 13 (8): 2052–7. doi:10.1097/01.ASN.0000022006.49966.F8. PMID 12138136.

[15] Neary J, Dorman A, Campbell E, Keogan M, Conlon P (July 2002). "Familial membranoproliferative glomerulonephritis type III". Am. J. Kidney Dis. 40 (1): E1. doi:10.1053/ajkd.2002.33932. PMID 12087587.

Membranoproliferative glomerulonephritis
Classification and external resources
Micrograph of glomerulus in membranoproliferative glomerulonephritis with increased mesangial matrix and increased mesangial cellularity. Kidney biopsy. PAS stain.
ICD-10	N00-N08 with .5 and .6 suffix
ICD-9	581.2, 582.2, 583.2
OMIM	609814 305800
DiseasesDB	34457
MedlinePlus	000475
eMedicine	med/887
MeSH	D015432
GeneReviews	Dense Deposit Disease/Membranoproliferative Glomerulonephritis Type II

匿名

検索

案内

dense deposit disease