J Korean Med Sci.  2012 Oct;27(10):1215-1221. 10.3346/jkms.2012.27.10.1215.

Dense Deposit Disease in Korean Children: A Multicenter Clinicopathologic Study

• Park SJ
• Kim YJ
• Ha TS
• Lim BJ
• Jeong HJ
• Park YH
• Lee DY
• Kim PK
• Kim KS
• Chung WY
• Shin JI

• KMID: 1778829
• DOI: http://doi.org/10.3346/jkms.2012.27.10.1215

Abstract

The purpose of this study was to investigate the clinical, laboratory, and pathologic characteristics of dense deposit disease (DDD) in Korean children and to determine whether these characteristics differ between Korean and American children with DDD. In 2010, we sent a structured protocol about DDD to pediatric nephrologists throughout Korea. The data collected were compared with previously published data on 14 American children with DDD. Korean children had lower 24-hr urine protein excretion and higher serum albumin levels than American children. The light microscopic findings revealed that a higher percentage of Korean children had membranoproliferative glomerulonephritis patterns (Korean, 77.8%; American, 28.6%, P = 0.036), whereas a higher percentage of American children had crescents (Korean, 0%; American, 78.6%, P < 0.001). The findings from the electron microscopy revealed that Korean children were more likely to have segmental electron dense deposits in the lamina densa of the glomerular basement membrane (Korean, 100%; American, 28.6%, P = 0.002); mesangial deposit was more frequent in American children (Korean, 66.7%; American, 100%, P = 0.047). The histological findings revealed that Korean children with DDD were more likely to show membranoproliferative glomerulonephritis patterns than American children. The degree of proteinuria and hypoalbuminemia was milder in Korean children than American children.

Keyword

Dense Deposit Disease; Membranoproliferative Glomerulonephritis; Electron-Dense Deposit

MeSH Terms

Adolescent
Asian Continental Ancestry Group
Child
Child, Preschool
Creatinine/blood
Edema/etiology
Female
Glomerulonephritis, Membranoproliferative/*pathology
Hematuria/etiology
Humans
Infant
Infant, Newborn
Male
Microscopy, Electron
Proteinuria/etiology
Republic of Korea
Serum Albumin/analysis
United States
Serum Albumin
Creatinine

Figure

• 

  Fig. 1 Light, immunofluorescence, and electron microscopy findings in a Korean case of dense deposit disease. (A) Cellular proliferation leads to lobule formation in the glomerulus (H&E, × 200). (B) The glomerular capillary wall is thickened focally, but the doubling or splitting observed in type I MPGN is not observed (arrow) (Periodic acid methenamine silver, × 400). (C) C3 immunofluorescence deposits along the glomerular capillary wall have a linear rather than a granular pattern (× 200). (D) Intramembranous electron dense deposits with a ribbon or sausage shape (arrows) are visible under the electron microscope (× 4,000).

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