Clinicopathologic characteristics of dense deposit disease

Objective To investigate the clinicopathologic characteristics of dense deposit disease (DDD) . Methods Clinical and pathologic data from 5 patients with DDD were collected and related references were reviewed Results Among 2499 patients with pathologically proven primary glomerular dieases DDD accounted for 0. 2% and 2% of membranoproliferative glomerulonephritis(MPGN). Three of the 5 DDD patients with nephrotic syndrome had MPGN. Other 2 patients with chronic nephritic syndrome had MPGN or mesangial proliferative glomerulonephritis respectively. Depressed serum C _3 were present in patients with MPGN. Immunofluorescent revealed granular C_3 deposit heavily alone capillary wall of glomeruli and large globular masses of C_3 in many mesangial areas in 4 patients. By electron microscopy 5 patients had the characteristic alterations of diffuse and uniform electron-dense deposits in the glomerular capillary basement membranes. The electron-dense transformation also affected the basement membranes of Bowman's capsules and proximal tubules in 4 patients. Predisone did not show effect on the treatment in 2 DDD patients with nephrotic syndrome. Conclusions DDD has variable clinical features with different prognosis. Electron microscopic examination to demonstrate the intramembranous dense deposits is definitive diagnosis. Massive proteinuria, severe hypertension and pathologic changes may be unfavorable prognostic factors.