Glomerular Disease (Pathology) Flashcards
what is this showing?
a normal glomerulus

what can be seen either side of the glomerulus?
Need 2 small arterioles on either side to regulate blood pressure other wise the capillaries will burst

a
Podocyte

b
Red blood cell in capillary loop

c
Endothelial cell lining capillary loop

what is a Podocyte?
Podocytes are cells in the Bowman’s capsule in the kidneys that wrap around capillaries of the glomerulus. Podocyte cells make up the epithelial lining of Bowman’s capsule, the third layer through which filtration of blood takes place
where does blood enter the glomerulus?

Blood is filtered across glomerular membrane, what is not?

From outside podocytes have what?
From outside podocytes have interdigitating ‘fingers’ or foot processes

Filter barrier = membrane = 3 things, what are they?
endothelial cell cytoplasm, basal lamina and podocyte

what is the Mesangium?
The mesangium is a space which is continuous with the smooth muscles of the arterioles. It is outside the capillary lumen, but surrounded by capillaries. It is in the middle (meso) between the capillaries (angis)
Mesangial cells = ‘tree-like’ group of cells which support capillaries

where does filtrate flow?

where do the things that cannot be filtered into bowmens space go?
Blood cells, some fluid and albumin and larger proteins exit via efferent arteriole

what is Glomerulonephritis?
= Disease of glomerulus
Can be inflammatory or non-inflammatory
Glomerulonephritis is inflammation of the tiny filters in your kidneys (glomeruli). Glomeruli remove excess fluid, electrolytes and waste from your bloodstream and pass them into your urine. Glomerulonephritis can come on suddenly (acute) or gradually (chronic)
what is the aetiology of Glomerulonephritis?
Some are due to immunoglobulin deposition
Some are diseases with no immunoglobulin deposition – for example - diabetic glomerular disease
Is Glomerulonephritis just one disease?
- Large range of conditions
- Difficult to cover all variants
what are 4 common presentations of Glomerulonephritis?
- Haematuria (blood in urine)
- Heavy proteinuria (nephrotic syndrome)
- Slowly increasing proteinuria
- Acute renal failure
Case 1:
- 40 year old male
- Discoloured urine
- Dipstick urine – positive for blood
what are the main causes of Haematuria?
- Urinary tract infection
- Urinary tract stone
- Urinary tract tumour
- Glomerulonephritis - not as common of a cause as the ones above
case 1 continued:
- Send off urine culture
- Arrange hospital appointment for ultrasound examination
- Urine culture normal
- Ultrasound of abdomen – normal
- Check his clotting then proceed to renal biopsy: what is seen on biopsy?

Case 1 biopsy - what is seen on immunoflourescence?
(a method in biology that relies on the use of antibodies chemically labeled with fluorescent dyes to visualize molecules under a light microscope)
Immunoglobulin (of IgA type) and complement component C3 in mesangial area of all glomeruli
IgA deposits (yellow arrow) cause increased proliferation of mesangial cells

what is the aetiology of IgA glomerulonephritis?
unknown – Is excess antibody produced?
Excess antibody (IgA) sometimes present in serum, but this is also true of some people who do not have IgA glomerulonephritis
Why is IgA not removed by glomerulus?
Unknown, but probably very important part of cause of disease
Does IgA get filtered into urine?
No, the IgA is ‘stuck’ within the mesangium
Mesangium, not the filter membrane, becomes clogged with antibody
How does this cause red blood cells to escape into urine?
unknown











