membranoproliferative glomerulonephritis

Summary

Summary: Chronic glomerulonephritis characterized histologically by proliferation of MESANGIAL CELLS, increase in the MESANGIAL EXTRACELLULAR MATRIX, and a thickening of the glomerular capillary walls. This may appear as a primary disorder or secondary to other diseases including infections and autoimmune disease SYSTEMIC LUPUS ERYTHEMATOSUS. Various subtypes are classified by their abnormal ultrastructures and immune deposits. Hypocomplementemia is a characteristic feature of all types of MPGN.

Top Publications

  1. Jones G, Juszczak M, Kingdon E, Harber M, Sweny P, Burns A. Treatment of idiopathic membranoproliferative glomerulonephritis with mycophenolate mofetil and steroids. Nephrol Dial Transplant. 2004;19:3160-4 pubmed
    Treatment of adults with idiopathic membranoproliferative glomerulonephritis (IMPGN) is often unrewarding with approximately 60% of patients progressing to end-stage renal failure within 10 years...
  2. Salmon A, Kamel D, Mathieson P. Recurrence of IgM nephropathy in a renal allograft. Nephrol Dial Transplant. 2004;19:2650-2 pubmed
  3. Montes T, Goicoechea de Jorge E, Ramos R, Gomà M, Pujol O, Sanchez Corral P, et al. Genetic deficiency of complement factor H in a patient with age-related macular degeneration and membranoproliferative glomerulonephritis. Mol Immunol. 2008;45:2897-904 pubmed publisher
    Age-related macular degeneration (AMD) and membranoproliferative glomerulonephritis type II (MPGN2) are dense deposit diseases that share a genetic association with complement genes and have complement proteins as important components of ..
  4. Sethi S, Zand L, Leung N, Smith R, Jevremonic D, Herrmann S, et al. Membranoproliferative glomerulonephritis secondary to monoclonal gammopathy. Clin J Am Soc Nephrol. 2010;5:770-82 pubmed publisher
    b>Membranoproliferative glomerulonephritis (MPGN) is an immune complex-mediated glomerulonephritis characterized by subendothelial and mesangial deposition of immune complexes...
  5. Pickering M, de Jorge E, Martinez Barricarte R, Recalde S, Garcia Layana A, Rose K, et al. Spontaneous hemolytic uremic syndrome triggered by complement factor H lacking surface recognition domains. J Exp Med. 2007;204:1249-56 pubmed
    ..Age-related macular degeneration (AMD), atypical hemolytic uremic syndrome (aHUS), and membranoproliferative glomerulonephritis type II (MPGN2) are associated with polymorphisms or mutations in the FH gene (Cfh), suggesting ..
  6. Walker P, Ferrario F, Joh K, Bonsib S. Dense deposit disease is not a membranoproliferative glomerulonephritis. Mod Pathol. 2007;20:605-16 pubmed
    Dense deposit disease (first reported in 1962) was classified as subtype II of membranoproliferative glomerulonephritis in the early 1970s...
  7. Agbaht K, Pepedil F, Kirkpantur A, Yilmaz R, Arici M, Turgan C. A case of Kaposi's sarcoma following treatment of membranoproliferative glomerulonephritis and a review of the literature. Ren Fail. 2007;29:107-10 pubmed
    ..transplant has been well documented, there are a few KS cases in the literature associated with membranoproliferative glomerulonephritis or other glomerular diseases...
  8. Lu D, McCarthy A, Lanning L, Delaney C, Porter C. A descriptive study of individuals with membranoproliferative glomerulonephritis. Nephrol Nurs J. 2007;34:295-302; quiz 303 pubmed
    b>Membranoproliferative Glomerulonephritis (MPGN) is one of a group of glomerulonephritides that often begins in childhood and progresses to renal failure...
  9. Smith R, Alexander J, Barlow P, Botto M, Cassavant T, Cook H, et al. New approaches to the treatment of dense deposit disease. J Am Soc Nephrol. 2007;18:2447-56 pubmed
    ..Dense deposit disease (DDD; also known as membranoproliferative glomerulonephritis type II) is a prototypical rare disease...

More Information

Publications62

  1. Aresu L, Valenza F, Ferroglio E, Pregel P, Uslenghi F, Tarducci A, et al. Membranoproliferative glomerulonephritis type III in a simultaneous infection of Leishmania infantum and Dirofilaria immitis in a dog. J Vet Diagn Invest. 2007;19:569-72 pubmed
    In this report a 9-year-old female German Shepherd dog with a membranoproliferative glomerulonephritis (MPGN) type III associated with concomitant infection of Dirofilaria immitis and Leishmania infantum is presented...
  2. Smith K, Alpers C. Pathogenic mechanisms in membranoproliferative glomerulonephritis. Curr Opin Nephrol Hypertens. 2005;14:396-403 pubmed
    ..on the pathogenesis of a long recognized and poorly understood form of glomerular injury, membranoproliferative glomerulonephritis. This disease has received growing attention as it is the principal renal manifestation of ..
  3. Braun M, Stablein D, Hamiwka L, Bell L, Bartosh S, Strife C. Recurrence of membranoproliferative glomerulonephritis type II in renal allografts: The North American Pediatric Renal Transplant Cooperative Study experience. J Am Soc Nephrol. 2005;16:2225-33 pubmed
    b>Membranoproliferative glomerulonephritis type II (MPGN II) is an uncommon form of complement-dependent acquired renal disease...
  4. Bagheri N, Nemati E, Rahbar K, Nobakht A, Einollahi B, Taheri S. Cyclosporine in the treatment of membranoproliferative glomerulonephritis. Arch Iran Med. 2008;11:26-9 pubmed
    Therapeutic approach to patients with idiopathic membranoproliferative glomerulonephritis is still controversial. Because it is more common in developing countries, the studies about it are limited.
  5. Rose K, Paixao Cavalcante D, Fish J, Manderson A, Malik T, Bygrave A, et al. Factor I is required for the development of membranoproliferative glomerulonephritis in factor H-deficient mice. J Clin Invest. 2008;118:608-18 pubmed publisher
    The inflammatory kidney disease membranoproliferative glomerulonephritis type II (MPGN2) is associated with dysregulation of the alternative pathway of complement activation...
  6. Bartel C, Obermüller N, Rummel M, Geiger H, Hauser I. Remission of a B cell CLL-associated membranoproliferative glomerulonephritis Type I with rituximab and bendamustine. Clin Nephrol. 2008;69:285-9 pubmed
    In a 56-year-old white male patient, a membranoproliferative glomerulonephritis Type I was diagnosed after a 12-month history of low grade B cell lymphoma (Binet A). HIV, Hepatitis B and C serology were negative...
  7. Motoyama O, Sakai K, Ohashi Y, Mizuiri S, Hatori T, Iitaka K, et al. Membranoproliferative glomerulonephritis in a girl and her mother. Clin Exp Nephrol. 2009;13:77-80 pubmed publisher
    A girl and her mother were diagnosed as having membranoproliferative glomerulonephritis (MPGN) type I. Microscopic hematuria and proteinuria presented at 9 years of age in the mother and at 14 years in the daughter...
  8. Farah S, Fazelat A, Frei G. Treatment of subretinal neovascular membrane in a patient with membranoproliferative glomerulonephritis type II. Ophthalmic Surg Lasers Imaging. 2009;40:416-8 pubmed
    A 29-year-old woman with membranoproliferative glomerulonephritis type II presented with decreased vision due to choroidal neovascular membrane. She was treated with monthly intravitreal injections of bevacizumab...
  9. Guo S, Mühlfeld A, Wietecha T, Peutz Kootstra C, Kowalewska J, Yi K, et al. Deletion of activating Fcgamma receptors does not confer protection in murine cryoglobulinemia-associated membranoproliferative glomerulonephritis. Am J Pathol. 2009;175:107-18 pubmed publisher
    ..with thymic stromal lymphopoietin transgenic (TSLPtg) mice, which develop cryoglobulinemic membranoproliferative glomerulonephritis (MPGN)...
  10. Benz K, Amann K. Pathological aspects of membranoproliferative glomerulonephritis (MPGN) and haemolytic uraemic syndrome (HUS) / thrombocytic thrombopenic purpura (TTP). Thromb Haemost. 2009;101:265-70 pubmed
    In this paper, epidemiology, pathogenesis and typical morphological aspects of all three types of membranoproliferative glomerulonephritis (MPGN), of the haemolytic uraemic syndrome (HUS) as well as of thrombotic thrombopenic purpura (TTP)..
  11. Buob D, Copin M. [Mixed cryoglobulinemia-associated membranoproliferative glomerulonephritis, disclosing gastric MALT lymphoma]. Ann Pathol. 2006;26:267-70 pubmed
    We report a case of a mixed cryoglobulinemia-associated membranoproliferative glomerulonephritis, disclosing gastric lymphoma of MALT-type...
  12. Sathe P, Madiwale C. Strongyloidiasis hyperinfection in a patient with membranoproliferative glomerulonephritis. J Postgrad Med. 2006;52:221-2 pubmed
  13. Licht C, Heinen S, Jozsi M, Löschmann I, Saunders R, Perkins S, et al. Deletion of Lys224 in regulatory domain 4 of Factor H reveals a novel pathomechanism for dense deposit disease (MPGN II). Kidney Int. 2006;70:42-50 pubmed
    We report a novel pathomechanism for membranoproliferative glomerulonephritis type II (MPGN II) caused by a mutant Factor H protein expressed in the plasma...
  14. Yoshino A, Honda M, Kanegane H, Obata K, Matsukura H, Sakazume S, et al. Membranoproliferative glomerulonephritis in a patient with X-linked agammaglobulinemia. Pediatr Nephrol. 2006;21:36-8 pubmed
    Immune complex and complement systems play an important role in membranoproliferative glomerulonephritis (MPGN). X-linked agammaglobulinemia (XLA) is a primary immunodeficiency characterized by severe hypogammaglobulinemia...
  15. Licht C, Fremeaux Bacchi V. Hereditary and acquired complement dysregulation in membranoproliferative glomerulonephritis. Thromb Haemost. 2009;101:271-8 pubmed
    b>Membranoproliferative glomerulonephritis (MPGN) is a chronic progressive renal disease that is diagnosed on the basis of renal histological features...
  16. Abrera Abeleda M, Nishimura C, Smith J, Sethi S, McRae J, Murphy B, et al. Variations in the complement regulatory genes factor H (CFH) and factor H related 5 (CFHR5) are associated with membranoproliferative glomerulonephritis type II (dense deposit disease). J Med Genet. 2006;43:582-9 pubmed
    b>Membranoproliferative glomerulonephritis type II or dense deposit disease (MPGN II/DDD) causes chronic renal dysfunction that progresses to end stage renal disease in about half of patients within 10 years of diagnosis...
  17. Enriquez R, Sirvent A, Amorós F, Perez M, Matarredona J, Reyes A. Crescentic membranoproliferative glomerulonephritis and hypocomplementemic urticarial vasculitis. J Nephrol. 2005;18:318-22 pubmed
    We describe the association of crescentic membranoproliferative glomerulonephritis and hypocomplementemic urticarial vasculitis syndrome. A 39-year-old woman presented edema and proteinuria and later a non-pruritic urticarial rash...
  18. Appel G, Cook H, Hageman G, Jennette J, Kashgarian M, Kirschfink M, et al. Membranoproliferative glomerulonephritis type II (dense deposit disease): an update. J Am Soc Nephrol. 2005;16:1392-403 pubmed
    b>Membranoproliferative glomerulonephritis type II (MPGN II) is a rare disease characterized by the deposition of abnormal electron-dense material within the glomerular basement membrane of the kidney and often within Bruch's membrane in ..
  19. De S, Al Nabhani D, Thorner P, Cattran D, Piscione T, Licht C. Remission of resistant MPGN type I with mycophenolate mofetil and steroids. Pediatr Nephrol. 2009;24:597-600 pubmed publisher
    Very few studies have been published on how to treat children with membranoproliferative glomerulonephritis type I (MPGN I), and as yet there is only one report on the use of mycophenolate mofetil (MMF) in children with MPGN I...
  20. Cansick J, Lennon R, Cummins C, Howie A, McGraw M, Saleem M, et al. Prognosis, treatment and outcome of childhood mesangiocapillary (membranoproliferative) glomerulonephritis. Nephrol Dial Transplant. 2004;19:2769-77 pubmed
    ..Prognostic factors and outcome are incompletely known in childhood mesangiocapillary glomerulonephritis (MCGN). This study aimed to correlate renal outcome with clinical and histopathological variables...
  21. Ozkaya N, Cakar N, Ekim M, Kara N, Akkök N, Yalcinkaya F. Primary nephrotic syndrome during childhood in Turkey. Pediatr Int. 2004;46:436-8 pubmed
    ..However, recent studies from different countries have reported an increasing incidence of focal segmental glomerulosclerosis (FSGS) in children...
  22. Noris M, Remuzzi G. Translational mini-review series on complement factor H: therapies of renal diseases associated with complement factor H abnormalities: atypical haemolytic uraemic syndrome and membranoproliferative glomerulonephritis. Clin Exp Immunol. 2008;151:199-209 pubmed
    ..The new genetic and pathogenetic findings in these diseases and their clinical implications for the management and cure of patients are reviewed in this paper...
  23. Dragon Durey M, Fremeaux Bacchi V, Loirat C, Blouin J, Niaudet P, Deschenes G, et al. Heterozygous and homozygous factor h deficiencies associated with hemolytic uremic syndrome or membranoproliferative glomerulonephritis: report and genetic analysis of 16 cases. J Am Soc Nephrol. 2004;15:787-95 pubmed
    ..Among six patients with homozygous deficiency, four presented with membranoproliferative glomerulonephritis, and two with atypical hemolytic uremic syndrome (HUS)...
  24. Skerka C, Licht C, Mengel M, Uzonyi B, Strobel S, Zipfel P, et al. Autoimmune forms of thrombotic microangiopathy and membranoproliferative glomerulonephritis: Indications for a disease spectrum and common pathogenic principles. Mol Immunol. 2009;46:2801-7 pubmed publisher
    ..that Thrombotic Thrombocytopenic Purpura (TTP), atypical Hemolytic Uremic Syndrome (aHUS) and Membranoproliferative Glomerulonephritis (MPGN), especially subtype II (also termed Dense Deposit Disease) represent a spectrum of related ..
  25. Alchi B, Jayne D. Membranoproliferative glomerulonephritis. Pediatr Nephrol. 2010;25:1409-18 pubmed publisher
    b>Membranoproliferative glomerulonephritis is an uncommon kidney disorder characterized by mesangial cell proliferation and structural changes in glomerular capillary walls...
  26. Kai H, Shimizu Y, Hagiwara M, Yoh K, Hirayama K, Yamagata K, et al. Post-MRSA infection glomerulonephritis with marked Staphylococcus aureus cell envelope antigen deposition in glomeruli. J Nephrol. 2006;19:215-9 pubmed
    ..Focal subendothelial widening accompanied with monocytes or foam cell infiltration was also seen. The findings reflect a typical post-MRSA infection glomerulonephritis caused by S.aureus cell envelope antigen...
  27. Morimoto J, Hasegawa Y, Fukushima H, Uesugi N, Hisano S, Saito T, et al. Membranoproliferative glomerulonephritis-like glomerular disease and concurrent tubulointerstitial nephritis complicating IgG4-related autoimmune pancreatitis. Intern Med. 2009;48:157-62 pubmed
    ..We describe here a patient with membranoproliferative glomerulonephritis-like glomerular disease, together with tubulointerstitial nephritis, idiopathic thrombocytopenic ..
  28. D souza Y, Jones C, Short C, Roberts I, Bonshek R. Oligosaccharide composition is similar in drusen and dense deposits in membranoproliferative glomerulonephritis type II. Kidney Int. 2009;75:824-7 pubmed publisher
    ..Lesions similar in appearance to drusen are also found in the fundi of patients with membranoproliferative glomerulonephritis type II (dense deposit disease, DDD)...
  29. Alpers C, Smith K. Cryoglobulinemia and renal disease. Curr Opin Nephrol Hypertens. 2008;17:243-9 pubmed publisher
    ..Here we review the types of cryoglobulins, mechanisms of cryoglobulin formation, links between hepatitis C virus and renal disease, and current approaches to therapy...
  30. Walker P. Dense deposit disease: new insights. Curr Opin Nephrol Hypertens. 2007;16:204-12 pubmed
  31. Elmaci I, Senday D, Silav G, Ekenel F, Balak N, Ayan E, et al. Nocardial cerebral abscess associated with mycetoma, pneumonia, and membranoproliferative glomerulonephritis. J Clin Microbiol. 2007;45:2072-4 pubmed
    ..Nocardial soft tissue involvement, mycetoma, is well known. However, the fact that actinomycetoma can metastasize may not be as well appreciated. The association between nocardiosis and glomerulonephritis should be better clarified...
  32. Hassenstein A, Richard G. [Choroidal neovascularisation in type II membranoproliferative glomerulonephritis, photodynamic therapy as a treatment option--a case report]. Klin Monbl Augenheilkd. 2003;220:492-5 pubmed
    ..b>Membranoproliferative glomerulonephritis (MPGN) type II leads to AMD-similar changes ("pseudo-AMD") of the fundus with CNV as a ..
  33. Dizdar O, Kahraman S, Genctoy G, Ertoy D, Arici M, Altun B, et al. Membranoproliferative glomerulonephritis associated with type 1 diabetes mellitus and Hashimoto's thyroiditis. Nephrol Dial Transplant. 2004;19:988-9 pubmed
  34. Razukeviciene L, Bumblyte I, Kuzminskis V, Laurinavicius A. Membranoproliferative glomerulonephritis is still the most frequent glomerulonephritis in Lithuania. Clin Nephrol. 2006;65:87-90 pubmed
    ..In Lithuania renal biopsies (RB) have become routine since 1995. Our study attempted to analyze RB for 5 years in Lithuania...
  35. Bestard O, Cruzado J, Ercilla G, Gomà M, Torras J, Seron D, et al. Rituximab induces regression of hepatitis C virus-related membranoproliferative glomerulonephritis in a renal allograft. Nephrol Dial Transplant. 2006;21:2320-4 pubmed
  36. Berger S, Daha M. Complement in glomerular injury. Semin Immunopathol. 2007;29:375-84 pubmed
    ..regulatory molecules has established a role of complement in the haemolytic uremic syndrome and membranoproliferative glomerulonephritis, and genotyping for mutations of the complement system are already leaving the research ..
  37. Madala N, Naicker S, Singh B, Naidoo M, Smith A, Rughubar K. The pathogenesis of membranoproliferative glomerulonephritis in KwaZulu-Natal, South Africa is unrelated to hepatitis C virus infection. Clin Nephrol. 2003;60:69-73 pubmed
    Idiopathic membranoproliferative glomerulonephritis (MPGN) is a well-defined clinicopathological entity with a poor prognosis, with 50% of patients progressing to end stage renal disease (ESRD) within 10 years...
  38. Iyoda M, Hudkins K, Becker Herman S, Wietecha T, Banas M, Guo S, et al. Imatinib suppresses cryoglobulinemia and secondary membranoproliferative glomerulonephritis. J Am Soc Nephrol. 2009;20:68-77 pubmed publisher
    ..in thymic stromal lymphopoietin transgenic mice, a model of cryoglobulinemia and associated membranoproliferative glomerulonephritis (MPGN), in which some glomerular manifestations likely result from PDGF receptor activation...
  39. Ootaka T, Saito T, Soma J, Sato H, Abe K. Glomerulointerstitial interaction of adhesion molecules in IgA nephropathy and membranoproliferative glomerulonephritis. Am J Kidney Dis. 1997;29:843-50 pubmed
    ..with two different proliferative glomerulonephritides: 43 with IgA nephropathy (IgAN) and 26 with membranoproliferative glomerulonephritis (MPGN)...
  40. Stokes M, Wood B, Alpers C. Membranoproliferative glomerulonephritis associated with low-grade B cell lymphoma presenting in the kidney. Clin Nephrol. 2002;57:303-9 pubmed
    ..Low-grade B cell lymphoma of mucosa-associated tissue type (MALToma) rarely may involve the kidney. Membranoproliferative glomerulonephritis (MPGN) is an uncommon complication of B cell lymphoma and may be related to cryoglobulin and/or ..
  41. Jansen J, Høgåsen K, Harboe M, Hovig T. In situ complement activation in porcine membranoproliferative glomerulonephritis type II. Kidney Int. 1998;53:331-49 pubmed
    Pigs genetically deficient in complement factor H all develop lethal membranoproliferative glomerulonephritis (MPGN) type II characterized by massive glomerular deposits of complement, intramembranous dense deposits, and mesangial ..
  42. Endo M, Ohi H, Ohsawa I, Fujita T, Matsushita M. Complement activation through the lectin pathway in patients with Henoch-Schönlein purpura nephritis. Am J Kidney Dis. 2000;35:401-7 pubmed
    ..These results suggest that complement activation through the lectin pathway was involved at the onset of HSPN, and this mechanism might be important in the disease pathogenesis...
  43. Han B, Kim M, Karl E, Hong S, Choi S. A case of membranoproliferative glomerulonephritis associated with a hydatidiform mole. Yonsei Med J. 2000;41:407-10 pubmed
    We treated a 54-year-old woman who was suffering from membranoproliferative glomerulonephritis associated with a complete type of hydatidiform mole. The renal manifestations were proteinuria and hematuria...
  44. Salazar Exaire D, Rodriguez A, Galindo Rujana M, Briones J, Arenas Osuna J, Rocha L, et al. Membranoproliferative glomerulonephritis associated with a mixed-cell germinal ovary tumor. Am J Nephrol. 2001;21:51-4 pubmed
    ..The association between membranoproliferative glomerulonephritis and mixed-cell germinal ovary tumor has not been previously reported.
  45. West C, Witte D, McAdams A. Composition of nephritic factor-generated glomerular deposits in membranoproliferative glomerulonephritis type 2. Am J Kidney Dis. 2001;37:1120-30 pubmed
    ..in which the function of factor H is blocked, a dysfunction also produced by NFS: Second, in membranoproliferative glomerulonephritis (MPGN) type 2, subepithelial deposits on the paramesangial portion of the glomerular basement ..
  46. Schwertz R, Rother U, Anders D, Gretz N, Scharer K, Kirschfink M. Complement analysis in children with idiopathic membranoproliferative glomerulonephritis: a long-term follow-up. Pediatr Allergy Immunol. 2001;12:166-72 pubmed
    Fifty children with idiopathic membranoproliferative glomerulonephritis (MPGN), aged 2-14 years at apparent onset, were monitored for the presence of C3 nephritic factor (C3 NeF) and signs of complement activation in serum...
  47. Suzuki T, Yonemura K, Miyaji T, Suzuki H, Takahira R, Fujigaki Y, et al. Progressive renal failure and blindness due to retinal hemorrhage after interferon therapy for hepatitis C virus-associated membranoproliferative glomerulonephritis. Intern Med. 2001;40:708-12 pubmed
    We treated a 67-year-old Japanese woman with membranoproliferative glomerulonephritis (MPGN) and chronic active hepatitis associated with hepatitis C virus (HCV) infection...
  48. Hill P, Firkin F, Dwyer K, Lee P, Murphy B. Membranoproliferative glomerulonephritis in association with chronic lymphocytic leukaemia: a report of three cases. Pathology. 2002;34:138-43 pubmed
    ..Hence, we have examined the renal biopsies in three patients with CLL and glomerulonephritis...
  49. Neary J, Conlon P, Croke D, Dorman A, Keogan M, Zhang F, et al. Linkage of a gene causing familial membranoproliferative glomerulonephritis type III to chromosome 1. J Am Soc Nephrol. 2002;13:2052-7 pubmed
    b>Membranoproliferative glomerulonephritis (MPGN) type III is a chronic progressive renal disease of unknown cause...
  50. Philit J, Queffeulou G, Walker F, Gubler M, Dupuis E, Vrtovsnik F, et al. Membranoproliferative glomerulonephritis type II and Niemann-Pick disease type C. Nephrol Dial Transplant. 2002;17:1829-31 pubmed
  51. Kurtz K, Schlueter A. Management of membranoproliferative glomerulonephritis type II with plasmapheresis. J Clin Apher. 2002;17:135-7 pubmed
    b>Membranoproliferative glomerulonephritis type II (MPGN II) is a rare kidney disease identified microscopically by electron-dense deposits surrounded by complement component C3 in glomerular basement membranes...
  52. Huang S, Costa D, Gross N, Yannuzzi L. Peripheral drusen in membranoproliferative glomerulonephritis type II. Retina. 2003;23:429-31 pubmed
  53. Akashi Y, Inoh M, Gamou N, Yoshimune N, Kinashi M, Ohbayashi S, et al. Macroglobulinemia and membranoproliferative glomerulonephritis in a hepatitis C virus-positive patient. Clin Nephrol. 2003;60:49-52 pubmed
    ..Renal histological examination demonstrated membranoproliferative glomerulonephritis (MPGN), and type 2 cryoglobulinemia was positive in her serum...