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Research Letter
April 13, 2009

Extensive Drusen in Type I Membranoproliferative Glomerulonephritis

Arch Ophthalmol. 2009;127(4):577-579. doi:10.1001/archophthalmol.2009.38

A case of extensive drusen formation associated with type I membranoproliferative glomerulonephritis (MPGN) is reported. Although similar findings have been noted with type II MPGN, to our knowledge this association has not been previously described in type I MPGN.

A 26-year-old woman was noted to have a fundus abnormality during a routine eye examination. Her medical history was significant for proteinuria and biopsy-confirmed type I MPGN developing in conjunction with meningococcal meningitis and meningococcemia 7 years previously. Serological analyses then showed low C3 and total complement levels. Renal biopsy with light and electron microscopy showed mesangial interposition, scattered subendothelial deposits, abundant immune complex deposits within the mesangium, and focal thickening of the glomerular basement membrane, consistent with type I MPGN. A repeat biopsy 5 years later showed immunohistopathologic staining of IgM and C3 in the mesangial capillary wall and glomerular basement membrane but no dense deposits indicative of type II MPGN. Her mother had senile cataracts. Two siblings were noted to have “normal eye exams” performed elsewhere.