GLOMERULAR INVOLVEMENT WITH VIRAL INFECTIONS Flashcards
What type of voral infection is associated with nephrotic syndrome?
EBV INFECTION
What is the most common risk factor for HIVAN?
IV DRUG USE
What are the 2 clinical features of HIVAN?
- nephrotic range proteinuria (often massive)
- Renal insufficiency
What is the average size of kidneys on renal ultrasound in HIVAN?
12cm
What is the characteristic LM pattern of HIVAN?
FSGS COLLAPSING TYPE
What happens to the visceral epithelial cells in HIVAN?
hypertrophy and hyperplasia
What is the IF staining in HIVAN?
• IgM
• C3
What is the most common EM findings in patients with HIVAN?
TRIs (in glomerular and visceral epithelial cells)
What are the 24-nm interanastomosing tubular structures found within the dilated cisternae of the endoplasmic reticulum?
TUBULORETICULAR INCLUSIONS
What is an important reservoir for HIV?
RENAL EPITHELIAL CELLS
What gene is found to be essential in producing HIV-induced changes?
NEF GENE
What gene is associated with a 29-fold higher odds for HIVAN in black patients?
APOL1 GENE
What is the mechanism whereby APOL1-risk variants associate with HIVAN?
defective podocyte autophagy
What is the prerequisite for renal transplant in pxs with HIV?
- undetectable viral loads
- CD4 over 200 cells/µL
DURATION: at least 6 months.
In the pre-cART era what is the most common form of glomerulopathy found in HIV-infected patients?
HIVAN
