J Int Med Sci, cilt.2, ss.31-36, 2006 (Diğer Kurumların Hakemli Dergileri)
Membranous glomerulopathy (MGN) is characterized by subepithelial immune complex deposits and glomerular basement membrane thickening. İt is the most common cause of the nephrotic syndrome in adults. While the majority of cases of MGN are idiopathic (IMN), secondary forms can be seen in the setting of autoimmune disease, neoplasia, infection, and following exposure to certain therapeutic agents. A general rule of thumb for the 10-year prognosis of untreated MGN is that 1/3 of cases will enter remission, 1/3 of cases will have persistent proteinuria, and 1/3 of cases will go on to develop end stage renal disease. In contrast, combined regimens using steroids plus cytotoxic agents (i.e., chlorambucil or cyclophosphamide) have proven effective. Most investigators agree that the effect is evident within short term use of cyclosporine (CsA) therapy. Other immunsupressive agents, such as mycophenolate mofetil and tacrolimus, currently are under study; however, data are insufficient to support their routine use.