Causes of nephrotic syndrome

Question 1

Primary causes

Answer 1

Focal segmental glomerulosclerosis
Membranous glomerular disease
Minimal change disease

Question 2

What types of visualisation do you do for these conditions to see what it could be?

Answer 2

Light microscopy
Electron microscopy
Immunofluorescence

Question 3

What can be seen in FSGS in light/electron/immunofluorescence?

Answer 3

Light - segments of fibrosis, hyalinosis
Electron - loss of podocyte foot processes
Immunofluorescence - no immune deposits

Question 4

What can be seen in membranous glomerular disease in light/electron/immunofluorescence?

Answer 4

Light - BM thickening
Electron - subendothelial spikey deposits and loss of podocytes
Immunofluorescence - immune complexes along the ENTIRE GBM

Question 5

What can be seen in minimal change disease in light/electron/immunofluorescence?

Answer 5

Light - nothing
Electron - Loss of podocytes
Immunofluorescence - No immune desposits

Question 6

Firstline management for all three

Answer 6

Steroids

Question 7

Antibody seen in membranous glomerular disease

Answer 7

Phospholipase A2

Question 8

Cause of minimal change disease

Answer 8

Unknown, but associated with asthma, eczema, allergy

Question 9

Cause of membranous glomerular disease

Answer 9

IgG anti-phospholipase A2
Primary - idiopathic, SLE
Infection, drugs, malignancy

Question 10

Cause of FSGS

Answer 10

Idiopathic
Secondary to drugs, HIV, obesity, lymphoma

Question 11

Three secondary causes of nephrotic syndrome

Answer 11

Amyloidosis
SLE
Diabetes