Glomerular Disease 2 Flashcards
What is Primary glomerulonephritis?
When there is inflammation of the tiny filters of the kidney (glomeruli) that originates from pathology in the kidney.
What is Secondary glomerulonephritis?
When there is inflammation of the tiny filters of the kidney (glomeruli) that comes about secondary to another pathology.
Examples of primary GN causes?
Post streptococcal GN, Crescentic GN, Minimal change disease, membranous GN, IgA nephropathy
Examples of secondary GN causes?
- Hypertension,Diabetes,SLE, Good pastures, amyloidosis, HSP, Wegner’s
Antibody mediated injury to the glomerulus is what type of HSR?
Type 2
What type of HSR is circulating immune complex deposition that causes glomerular injury?
Type 3
What type of HSR is cytotoxic Ab that cause glomerular injury?
Type 3 HSR
What type of HSR are cell mediated immune injuries to the glomerulus?
Type 4 HSR
What type of injury is activation of alternative complement pathway leading to glomerular injury?
Type 4 HSR.
Be able to recreate and understand this slide.
Be able to understand this slide and reproduce it.
What is anti GBM GN?
in situ immune complex deposition
Autoimmune diseases, caused by antibodies against
noncollagenous domain (NCI ) of the α chain of collagen type IV
Characteristic damage, deposition pattern, and progression of Anti GBM GN?
severe crescentic glomerular damage
Linear pattern of Immune complex deposition
clinical syndrome of rapidly progressive glomerulonephritis- rapidly progressing AFR
Another name for idiopathic membranous GN?
Heymann nephritis
What is the cause of Heymann Nephritis?
from the reaction of ab with an antigen complex located on the basal surface of visceral epithelial cells - HEYMANN
ANTIGEN
What pattern of deposition can be found in a person with Heymann nephritis?
IF (immunofluoresence) - granular pattern - sub epithelial localization
What are the names of the different types of GN that are caused by immune complex deposition?
Poststreptococcal GN, membranous GN,MPGN
Describe the factors affecting localization of antigen, antibody, or complexes around parts of the glomerulus.
Because the membrane is negatively charged…..
Small Molecules Highly cationic
Sub epithelial
Highly anionic macromolecules- Sub Endothelial
neutral charge - mesangium
In IF is a granular pattern related to membranous GN or Anti GBM?
membranous GN
In IF is a linear pattern related to anti GBM disease or membranous GN?
anti GBM disease
Linear basement membrane localization of ag, ab, or complexes could be characteristic of what conditions?
anti GBM GN / Good pastures
What glomerular pathologies could contain sub endothelial deposits?
MPGN type 1 (membranoproliferative GN type1 ) & SLE (also sub epi & mes)
Why renal pathology has characteristic sub epithelial humps?
post streptococcal GN, membranous (Heymenn nephritis)
What type of nephropathy has only mesangial deposits?
IgA nephropathy
What type of nephropathy has no immune deposits?
Minimal change disease, Idiopathic FSGS, Wegner’s granulomatosis, Alports/thin basement membrane disease
In what glomerular disease conditions is C3 in blood low?
MPGN type II (persitentantly low)
Post streptococcal GN (transiently low)
IgA nephopathy
Another name for MPGN type II
Dense Deposit Disease
Be able to explain this graph and how this leads to low C3 in the blood.
Activation of the alternative pathway C3 converts is initiated.
In the body Properidin usually stabilized this pathway so C3 convertase not broken down by I, and H proteins.
In people with C3NeF autoantibody in MPGN Type 2 it will stabilize C3 convertase and more inflammation and damage will occur
C3 constantly being used and therefore less will be in blood.
Describe diffuse involvement of glomeruli
involving all glomeruli > 50% of them
Describe Global involvement histopathology in renal system.
entire glomerulus
Describe focal involvement in histological slides of glomerulus.
affecting few glomeruli < 50%
Describe segmental involvement of glomerulus histopathology.
inv. only a proportion of a few glomerulus
Be able to reproduce the chart.
Reproduce chart
What is the condition being seen here and what can it be caused by?
mesangial proliferative GN
Caused by:
IgA nephropathy
What is the condition being seen in this biopsy and what is the cause?
Proliferation of endothelial cells, epithelial cells & neutrophilic infiltration
Acute/ Diffuse proliferative GN
Cause:
Post Streptococcal/ post infectious GN
Describe what is being seen here.
What is the condition?
proliferation of parietal cells of Bowmans capsule
Crescentic GN
What inflammatory mediators can be leaked through the BM of one with Crescentic GN?
IL-1; TNF; INF-y
What is a characteristic feature of membranous GN?
thickening of Glomerular BM
Thickening of BM proper of the glomerulus may indicate what condition?
DM
Deposition of what electron dense deposits can lead to Membranous GN?
Lupus nephritis, amyloid-amyloidosis, cryoglobulines
What is seen in here?
What is the condition and what are the causes?
membranous GN
Thickening of the membrane on PAS
idiopathic, Hep B, malignancy Lupus V, DM
What causes what is seen in this image?
Accumulation of extracellular amorphous substance - end result of various glomerular damage
Hyalinisation (Scelrosis) Diffuse
List some Nephrotic syndromes.
MCD,
FSGS
Membranous GN
Diabetic nephropathy
Amyloidosis
List the Nephritic syndromes
Post Strep GN
RPGN (ARF)
Alports
Thin BM Disease
Name some mixed or (Nephrotic nephritic conditions)>
MPGN
Lupus GN
Frank gross/microscopic hematuria/cola colored urine represents what condition?
IgA nephropathy
What stains should be done upon renal biopsy to determine condition of renal disease?
H&E, special Stains- PAS, PASM for Basement membrane changes
After renal biopsy what should be done for diagnosis of glomerulonephropathy?
IF or EM
If there is a lady with GN what should be done?
ANA & Anti Ds DNA
IF positive diagnosis could be what GN?
IgA nephropathy; Good pastures syndrome
IF negative GN could be what conditions?
Alports; Wegner’s; Minimal change disease; FSGS
What auto antibodies should be checked for when trying to determine GN?
anti GBM; C-ANCA; C3 nephritic factor
