DIFFUSE THIN GLOMERULAR-BASEMENT-MEMBRANE IN ASSOCIATION WITH IDIOPATHIC MEMBRANOUS GLOMERULONEPHRITIS

Here we present a rare report of diffuse thin glomerular basement memb rane (dTGBM) with idiopathic membranous glomerulonephritis (IMGN). dTG BM was found in 11 (2.04%) of 539 adult patients with IMGN. The male:f emale ratio was 1:1.2. Sixty patients with IMGN alone (matched for age and sex) were adjusted and analyzed as control patients. There was no significant difference in the clinical and laboratory data between th e two groups except for the microhematuria, which was more frequently found in the dTGBM associated IMGN group (dTGBM + IMGN) (10/11, 91%) t han in the IMGN group (19/60, 31.7%), and the difference was significa nt (p < 0.001). However, no statistical difference was found in morpho logical parameters between the two groups except in the thickness of t he glomerular basement membrane (GBM). In this study, using specific m onoclonal antibodies against the chains of type IV collagen, no change in quality or location tin abberant or no expression) was found in th e collagenous composition of the dTGBM compared to the normal GEM. No prominent thickening or transformation of the GEM, which is characteri stic for MGN, developed in the dTGBM + IMGN cases or IMGN, As a result , we could not detect any difference in the prognosis between these tw o groups. These findings support the view that IMGN can occur in patie nts with dTGBM, and the dTGBM patients may recover completely, The pos sible coexistence of these diseases was thus hypothesized due to the p ersisting microhematuria.