Clinical Nephrotic Syndrome Flashcards
complement w/ nephrotic syndromes
should be normal, can be low w/ membranous nephropathy associated w/ SLE
MCD patho
LM- normal
IF- negative
EM- diffuse effacement of foot processes
MCD etiologies
often primary, can be triggered by infection or immune stimulus
secondary to lymphoma or drugs like NSAIDs
tx for MCD
steroids- usually very responsive
age group for MCD
most common nephrotic syndrome in kids
dx of nephrotic syndrome
massive proteinuria-over 3.5 g/day (same as Protein/Cr ratio)
fatty casts and oval fat bodies on sediment
hypoalbuminemia, hyperlipidemia, hypercoaguable, hypogammaglobulinemia (risk of infection)
FSGS patho
LM- segmental sclerosis and hyalinosis
IF- negative
EM- effacement of foot processes
etiologies of FSGS
primary
secondary to HIV, parvo, heroin, SCD, cyanotic heart disease, obesity, interferon, glomerular overwork
FSGS populations
most common in african american and hispanic
tx of FSGS
poor response to steroids, can progress to CKD
dialysis and transplant
membranous nephropathy patho
LM- diffuse capillary and GBM thickening, no hypercellularity
IF- granular immune complex deposition
EM- spike and dome subepithelial deposits
membranous population
most common nephrotic syndrome in caucasians
membranous etiology
primary: autoAb to PLA2 receptor
secondary to HBV, HCV, SLE, syphilis, drug induced (gold, NSAIDs), paraneoplasm
amyloid patho
LM- apple green w/ polarized congo red, esp in mesangium
amyloid etiology
AL form- plasma cell disorder, myeloma
AA form- assoc w/ chronic infection
