GLOMERULAR MANIFESTATIONS OF LIVER DISEASE Flashcards
Wjat type of pattern is fpund in most cases od hepatitis B–associated nephropathy?
MN
What are the 2 other patterns seen in HBV nephropathy?
- MPGN TYPE 3
- CRESCENTIC GN
What medication do not significantly improve proteinuria and may potentially enhance viral replication?
STEROIDS
What nucleoside analog reduce proteinuria and lead to a lesser incidence of ESKD in patients with hepatitis B–associated nephropathy?
LAMIVUDINE
What are the 3 current recommended nucleoside analogs for Hep B-related GN?
- Tenofovir
- entecavir
- pegylated IFN-α-2a
Why is lamivudine no longer recommended in the treatment of Hep B related-GN?
high rate of drug resistance
What is the most common immune complex type in Hep C infection?
MPGN
What pattern is associated with HCV and may cause a systemic vasculitis?
Mixed cryoglobulinemia
What medication is associated with improvement in vasculitis in Hep C-related GN?
DAA DRUGS (DIRECT ACTIVE ANTIVIRAL DRUGS)
What are the 2 distinct clinical lesions associated with Autoimmune chronic hepatitis?
- GN
- Interstitial nephritis
What are the 2 patterns of autoimminue chronic hepatitis on renal biopsy?
- MN
- MPGN
What are the 2 patterns on histology in liver cirrhosis?
- mesangial sclerosis (cirrhotic glomerular sclerosis)
- MPGN
What is the lesion found in renal biopsies of patients with cirrhosis on LM showing an increase in mesangial matrix with little or no increase in mesangial cellularity?
HEPATIC GLOMERULOPATHY
What Ig is elevated in over 90% of cirrhotic patients with glomerular deposition?
IgA
What is the pathogenesis of Liver cirrhosis-associated GN?
Defective hepatic clearance of IgA as well as altered processing and/or portacaval shunting of circulating immune complexes
