Dobson Renal Path #3 Flashcards
What is associated with a Linear IF pattern?
GBM issue
What has subepithelial humps?
acute proliferative GN, SpeB
What has membranous deposits?
Membranous nephropathy and Heymann nephritis
Subendothelial deposits?
Lupus nephritis and membranoperoliferative GN
Mesangial deposits?
IgA nephropathy
What is a key event for the development of protieinuria?
breakdown of slit diaphragms in glomerular membrane
Pathogenesis of membranous nephropathy? Gomerular pathology light and IF?
- in situ immune complex PLA2R antigen in cases of primary disease
- DIffuse capillary wall thickening
- granular IgG and C3
- spike and dome
Main clinical features of nephritic syndrome?
- Hematuria
- rbc and casts
- Proteinuria
- with or w/o edema
- Azotemia
- Htn
Minimal change disease pathogenesis, glomerular pathology light and EM?
- loss of glomerular polyanion with podocyte injury
- normal light microscopy with lipids in tubules
- EM shows effacement of foot processes with no deposits
Histology of acute proliferative posinfectious GN?
- diffuse proliferation fo glomerular cells associated with influx of leukocytes caused by immmune complexes
What is a common cause of post infectious acute proliferative GN?
Group A beta hemolytic streptococci
What lab test would be used to document post streptococcal infections if you suspect post infectious GN?
ASO titer
In goodpasture syndrome, what are the renal and extra renal features, what lab findings will be helpful, patient demographics, treatments?
- teens-20’s M>F, smokers
- Kidneys and lungs hemoptysis and nephritic syndrome
- hematuria, htn, BUN Creatine elevated (azotemia)
- linear GBM fluorescence
- auto antibodies against noncollagenous domain of alpha 3 chain of collagen IV
- steroids
In lupus nephritis what are the renal and extra renal features, what lab findings will be helpful, patient demographics, treatments?
Subendothelial deposits, Class 1: least common
Class 4 (diffuse) is most common and severe form of lupus. involvement of >50% of all glomeruli. lateral crescents fill bowman’s space
loop wire! loopus
In HSP, what are the renal and extra renal features, what lab findings will be helpful, patient demographics, treatments?
- purpuric skin lesions on extensor surfaces and butt
- abdominal pain
- intestinal bleeding
- arthralgia
- renal in ⅓ patients following upper respiratory infection
- nephritic &/or nephrotic syndrome
- IgA deposited in glomerular mesangium similar to IgA nephropathy
- kids 3-8 yrs typically, but if an adult they have more severe renal manifestations
In IgA nephropathy, what are the renal and extra renal features, what lab findings will be helpful, patient demographics, treatments?
(Berger disease) most common type of GN worldwide
Nephritic: RPGN type 2, mesangial immune complex deposits, normal complement, concurrent infection, associated with celiac disease, recurrent hematuria
What is RPGN?
- aka cresentic GN
- severe glomerular injury that develops rapidly with progressive loss of renal function
- divided in 3 groups
- Type I (anti GBM)
- Type II (Immune complex)
- Type III (Pauci Immune)
If RPGN is untreated what happens?
- death from renal failure in weeks to months if untreated
- associated with loss of renal function, severe oliguria, and nephritic syndrome signs
Common histologic picture associated with RPGN?
Crescentic glomerulonephritis