Fourthly, glomerular punctate hemorrhage, a characteristic feature of IC, is believed to be caused by obesity-induced overexpression of inflammatory mediators, capillary endothelial growth factor, hypoxia-inducible factor, and tumor necrosis factor, leading to an increase in the surface layer of interstitial capillaries in the bladder. The gene discussed is TNF; the disease is obesity due to melanocortin 4 receptor deficiency.