6. Glomerular Causes of Haematuria Flashcards
What are the systemic causes of haematuria?
Clotting disorders
Low platelets
Warfarin
What are the renal causes of haematuria?
Glomerulonephritis Thin membranes Alport's syndrome Vasculitis Neoplasms
What is the most common cause of glomerulonephritis?
IgA glomerulonephritis
How does IgA glomerulonephritis appear on histology?
IgA immune complex deposits, especially in mesangium
Recruitment of macrophages
What system is used to give the prognosis for IgA glomerulonephritis?
Oxford staging system
Give the points of the Oxford Staging system
Mesangial cellularity increase Endocapillary inflammation Segmental sclerosis Tubulo-interstitial fibrosis Crescents
What is thin membrane nephropathy?
Also known as benign familial haematuria
Females may be carriers for Alport’s disease
What is Alport’s syndrome?
Sex linked collagen disease
Causes fragmentation of BM
What other abnormalities are associated with Alport’s syndrome?
Nerve deafness
Eye abnormalities
Describe the pathogenesis of ANCA vasculitis
Neutrophils are activated via inflammation
Parts of things they have phagocytosed protrude through cell wall
Antibody binds to MPO or PR3
Neutrophils aggregate and attack endothelial surface
How are crescents formed in ANCA vasculitis?
Capillary wall rupture means iron released in Bowman’s capsule
Macrophages in capsule try to digest iron
What is goodpasture syndrome?
IgG autoantibodies to type 4 collagen in BM
more severe than ANCA
Destroys BM so that blood can pass from capillary right into Bowman’s
What are the urinary tract causes of haematuria?
Carcinoma: ureter, bladder or prostate UTI or STD Calculi Urethral caruncle Catheters Benign hyperplasia of the prostate
