For example, one study used the following histological criteria: "Glomeruli with mesangial hypercellularity (four or more cells/mesangium with or without mesangial matrix expansion and immune complex deposits)". The histologic pattern of injury can also provide insight into the prognosis of the glomerular disorder. Mesangial proliferation indicates a mild, though active, lesion. Overall, a kidney biopsy should address the following:
Primary diagnosis, with clinical modifiers
Pattern of injury
Established score/class/grade of disease entities (i.e., lupus nephritis, IgA nephropathy)
Secondary diagnosis (i.e., ATN, interstitial nephritis, thrombotic microangiopathy)
Ancillary studies, if done (i.e., IgG sub typing)
Chronicity grade and scoreThe kidney biopsy is foundational to informing the diagnosis of mesangial proliferative glomerulonephritis, as it is a morphological pattern. Clinical Presentation
Mesangial proliferative glomerulonephritis often presents with hematuria (gross or microscopic) or nephrotic syndrome. Presentation can also include asymptomatic proteinuria. These presenting symptoms are relatively non-specific and are often seen in other glomerular disorders. Preceding upper respiratory tract infection or post-streptococcal glomerulonephritis may contribute to hematuria, as both have been identified in patients presenting with hematuria in the context of mesangial proliferative glomerulonephritis. Preceding infection was not as readily identified in patients presenting with either asymptomatic proteinuria or nephrotic syndrome. However, it has been shown patients presenting with nephrotic syndrome have some histo- and clinic-pathologic similarities to minimal change disease. Treatment
Treatment for glomerular disorders is often established for specific histological patterns. Presentations of hematuria in the context of mesangial proliferative glomerulonephritis often resolve spontaneously, with a relatively benign course.
creatine kinase
Anti-Jo-1 antibody testing
Electromyography
Muscle biopsy
Pulmonary function testing
Lung biopsy
Imaging such as High Resolution computed tomography In certain situations, testing of other antibodies, specific imaging (MRI, thoracic high resolution computed tomography), and swallowing evaluation may be needed. Treatment
Unfortunately, treatment for the anti-synthetase syndrome is limited, and usually involves immunosuppressive drugs such as glucocorticoids. For patients with pulmonary involvement, the most serious complication of this syndrome is pulmonary fibrosis and subsequent pulmonary hypertension.Additional treatment with azathioprine and/or methotrexate may be required in advanced cases. Prognosis
Prognosis is largely determined by the extent of pulmonary damage. References


== External links ==