Secondary membranous glomerulonephritis

Abstract

Membranous nephropathy, one of the most common causes of NS in adults, is uncommon in children, representing at most 5% of new cases of nephrotic syndrome in the pediatric age group. Similar to the adult population, the etiology of membranous nephropathy (MN) can be primary (idiopathic) or secondary. Both can be seen in all pediatric age groups from the neonate to the young adult. However, among children younger than 10 years, a secondary diagnosis is usually identified. The identification of the target antigen in primary MN, M type phospholipase A 2 receptor (PLA 2 R), and the increasing availability of testing for the PLA 2 R antibody has shaped significant research in primary MN over the course of the past decade. In contrast, the literature describing secondary MN in children is limited. Data is extrapolated from studies that originate in the adult population or from pediatric case reports or small case series. Secondary causes of membranous nephropathy in children include several broad categories including systemic autoimmune diseases, infections, drugs, and malignancy. Case reports have broadened this list to include several other systemic illnesses that have been associated with MN. The following review will focus on secondary membranous nephropathy, including the prevalence and epidemiology, the histopathology, clinical manifestations, and the specific etiologies with their pathogenesis and prognosis.