B5.042 Prework 2: Glomerulonephritis Flashcards
what is glomerulonephritis
any condition associated with inflammation of the glomerular tuft
what are 4 categories of classification of glomerulonephritis
causative disease
clinical syndrome
pattern of injury
pathology
causative diseases
renal
systemic
clinical syndromes
nephritic
nephrotic
patterns of injury
diffuse- more than 50% of glomeruli
focal- involve less than 50% of glomeruli
segmental- portions of the glomerulus
global- all glomerulus affected
pathology
membranous- thickening of glomerular capillary wall
proliferative- hypercellularity in glomerulus, mesangial expansion
membranoproliferative- combination of the above
glomerulosclerosis- sclerosis with capillary collapse
types of glomerulonephritis that lead to nephrotic syndrome
minimal change glomerulonephritis focal segmental glomerulosclerosis membranous glomerulonephritis diabetes nephropathy amyloidosis
types of glomerulonephritis that lead to nephritic syndrome
post-streptococcal glomerulonephritis
ANCA-associated
Alport syndrome
Goodpasture syndrome
characterize post-streptococcal glomerulonephritis
occurs after a Group A strep infection reduced C3-4 in first 6-8 weeks good prognosis, particularly in children hypercellular inflamed glomeruli immunocomplex deposition (sub-epi humps)
characterize ANCA associated glomerulonephritis/vasculitis
progresses in weeks to renal failure
can present as acute
serologic marker is ANCA
LM: crescent
characterize Alport syndrome
inherited alteration of type IV collagen
LM: thinning and splitting of BM
characterize Goodpasture syndrome
rare disease cause by anti-GMB antibodies
IgG: deposition along glomerular capillary loops
LM: fibrin in crescents
IF: linear or diffuse IgG staining
treat w steroids
glomerulonephritis that can lead to both nephrotic and nephritic syndrome
membrane proliferative glomerulonephritis
IgA nephropathy
lupus
characterize membrane proliferative glomerulonephritis
2 types: Ig+ with chronic antigenemia, and Ig- with alternative complement abnormalities
LM: double contours and lobular hypercellularity
EM: sub endothelial deposits
characterize the types of lupus nephropathy
I: no renal involvement
II: mesangial
III and IV: proliferative lupus, nephritic syndrome
v: membranous lupus present with nephrotic syndrome
EM: deposits everywhere, GBM may show dense deposits
epidemiology of IgA nephropathy
one of most common forms of glomerulonephritis worldwide
more common in adolescents and young adults
male to female 2-3:1
common in asians
signs and symptoms of IgA nephropathy
episodic hematuria after nonspecific URTI or GI or GU infection
henoch schonlein purpura, vasculitis
proteinuria and nephritis syndrome OR heavy proteinuria and nephrotic syndrome
pathology of IgA nephropathy
mesangial expansion
deposits of IgA
healing may lead to scerosis
pathogenesis of IgA nephropathy
increased polymeric IgA in blood
IgA abnormally glycosylated
IgA trapped in mesangium, causing it to proliferate
diagnosis of IgA nephropathy
urine test for blood/urine/casts
blood tests show kidney insufficiency
kidney biopsy to confirm diagnosis
treatment of IgA nephropathy
high BP meds
immunosuppressive drugs
omega 3s
