Glomerular Disease Flashcards
Focal Segmental glomerulosclerosis associated conditions
most common nephrotic syndrome in adults
a/w HIV, heroin abuse, massive obesity, interferon tx, CKD
FSGS pathology
sclerotic segments: BM collapse, inc matrix production, hyalinosis
Membranous nephropathy conditions
second most common cause of nephrotic syndrome in adults
c/b:
- idiopathic
- SLE
- infections
- drugs
- solid tumors
Membranous nephropathy pathology
LM diffuse capillary GBM thickening
EM “spike and dome” appearance with subepithelial deposits
IF granular
Minimal change disease pathology
selective loss of albumin, not globulins, caused by GBM polyanion loss (immune response mediated)
EM - effacement of foot processes
Amyloidosis
Congo red stain shows apple-green birefringence under polarized light
a/w MM, TB, RA
MPGN Type I a/w
HBV, HCV
subendothelial IC deposits with granular IF; “tram-track” appearance due to GBM splitting c/b mesangial ingrowth
MPGN type II a/w
C3 nephritic factor
intramembranous IC deposits = “dense deposits”
Diabetic glomerulonephropathy
nonenzyme glycosylation of GBM –> inc permeability and thickening –> inc GFR –> inc mesangial expansion
Pathology: GBM thickening, Kimmelstiel-Wilson lesion
Acute PSGN
nephritic
glomeruli enlarged and hypercellular, lots of neutros, “lumpy bumpy” appearance subendothelial on EM; IgG, IgM, and C3 deposition along GBM and mesangium
RPGN
nephritic, crescentic (fibrin and plasma proteins, eg C3b)
c/b Goodpasture’s, GPA (c-ANCA), MPA (p-ANCA)
DPGN
nephritic
c/b SLE, MPGN
path: wire looping capillaries, IgG based ICs often with C3 deposition)
Berger’s disease
IgA nephropathy, nephritic
a/w HSP
path: mesangial proliferation
Alport syndrome
nephritic, x-linked, split BM, mx in type IV collagen
a/w deafness and less commonly eye problems
