Clinical and pathology features of idiopathic membranous nephropathy accompanied by mesangial dense deposit

Objective To investigate clinical and pathological features of idiopathic membranous nephropathy (IMN) accompanied by mesangial dense deposit. Methods Clinical data of 46 patients who were diagnosed as IMN accompanied by mesangial dense deposit admitted to Zhejiang Provincial People's Hospital from January 2013 to December 2014 were retrospectively analyzed. They were compared with those of 29 patients who were diagnosed as IMN without mesangial dense deposit during the same period in the hospital. Analysis of their clinical and pathological features was conducted. Results The IMN accompanied by mesangial dense deposit accounted for IMN 61.3%, and had more hyaline changes of arteriole (43.5% vs 6.9%, P=0.001) and more obvious arteriolar wall thickening (78.2% vs 51.7%, P=0.016) than IMN without mesangial dense deposit. Furthermore, the positive rate of IgA deposition in IMN accompanied by mesangial dense deposit was greatly higher than that in IMN without mesangial dense deposit (21.7% vs 0, P=0.007). In other index, such as serum biochemical parameters, urine protein, glomerular lesion, tubulointerstitium pathological damage and other immunopathologic changes, no statistically significant differences were found between these two groups. Conclusions IMN patients accompanied by mesangial dense deposit have severe intrarenal artery lesions，and high positive rate of IgA deposition.