RESUMO
La glomerulonefritis membranoproliferativa mediada por complemento es una enfermedad rara, pero puede asociarse a alteraciones retinianas. Por ello, el propósito de este estudio fue valorar una serie de casos con dicho diagnóstico en seguimiento por nefrología en nuestro centro. Se realizó un estudio transversal de 8 pacientes diagnosticados de glomerulonefritis membranoproliferativa mediada por complemento. Se realizó funduscopia, tomografía de coherencia óptica (OCT) y angio-OCT de dominio Swept Source. Uno de los 8 pacientes presentaba depósitos drusenoides que se localizaron bajo el epitelio pigmentario retiniano en la OCT, descartándose la presencia de neovascularización coroidea asociada en la angio-OCT. Por tanto, la glomerulonefritis membranoproliferativa puede producir alteraciones retinianas con drusas o desprendimientos del epitelio pigmentario retiniano, por lo que debe hacerse un adecuado diagnóstico diferencial con la degeneración macular asociada a la edad. Es crucial realizar un seguimiento en estos pacientes ante las posibles complicaciones que pueden desembocar en una pérdida de visión
Complement-mediated membranoproliferative glomerulonephritis is a rare progressive glomerular disease. In some patients it can be associated with retinal lesions. Therefore, the purpose of this study was to assess a case series with this diagnosis in our hospital. A cross-sectional study was conducted on 8 patients diagnosed with complement-mediated membranoproliferative glomerulonephritis. Funduscopy, optical coherence tomography (OCT) and Swept Source domain OCT angiography were performed. Only 1 of the 8 patients showed drusen-like deposits that were located under the retinal pigment epithelium in the OCT, with the presence of associated choroidal neovascularization being ruled out in OCT angiography. Therefore, membranoproliferative glomerulonephritis may produce retinal alterations with drusen or retinal pigment epithelium detachment, and requires an appropriate differential diagnosis to be made with age-related macular degeneration. The follow-up of these patients is important in order to detect vision-threatening complications
Assuntos
Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Glomerulonefrite Membranoproliferativa , Retina/patologia , Pacientes/classificação , Tomografia/classificação , Epitélio/patologia , Drusas Retinianas/classificação , Degeneração Macular/classificação , Degeneração Macular/diagnósticoRESUMO
Complement-mediated membranoproliferative glomerulonephritis is a rare progressive glomerular disease. In some patients it can be associated with retinal lesions. Therefore, the purpose of this study was to assess a case series with this diagnosis in our hospital. A cross-sectional study was conducted on 8 patients diagnosed with complement-mediated membranoproliferative glomerulonephritis. Funduscopy, optical coherence tomography (OCT) and Swept Source domain OCT angiography were performed. Only 1 of the 8 patients showed drusen-like deposits that were located under the retinal pigment epithelium in the OCT, with the presence of associated choroidal neovascularization being ruled out in OCT angiography. Therefore, membranoproliferative glomerulonephritis may produce retinal alterations with drusen or retinal pigment epithelium detachment, and requires an appropriate differential diagnosis to be made with age-related macular degeneration. The follow-up of these patients is important in order to detect vision-threatening complications.
