Membranous nephropathy (MN) is an immune complex deposition disease. IgG and complements predominantly deposit beneath the podocytes on the sub-epithelial region of glomerular capillaries. Hence, the sub-epithelial deposits are considered to be pathognomonic for MN. Glomerular basement membrane (GBM) injury due to immune deposition causes podocyte structural damage which results in proteinuria. Autoimmune diseases, medications, malignancies, infections, among others, are responsible for generating antibodies that account for about 25% of MN (secondary MN). In about 75% of cases of MN, the inciting events for these immune depositions are not known, but specific antigen-antibody complexes have been discovered (primary MN).
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