Glomerular Pathology

Question 0

Explain the difference between nephrotic and nephritic syndrome

Answer 0

Nephrotic - proteinuria, low albumin, hyperlipidaemia, oedema, primary glomerulonephritis, secondary glomerulonephritis (to diabetes, lupus, sarcoidosis)
Nephritic - proteinuria (not severe), haematuria, low albumin, thin glomerular basement membrane, small pores in podocytes

Question 1

Describe the basic structural patterns of glomerular injury and their underlying mechanisms

Answer 1

Within glomerular basement membrane - minimal change glomerulonephritis, membranous glomerulonephritis (immune complex deposits)
Sub-epithelial - antibodies bind in situ, antigen lodged, IgA nephropathy –> renal failure
Mesangial/paramesangial - deposition of circulating IgA containing immune complexes
Sub-endothelial - vasculitis in association with Anti Neutrophil Cytoplasmic Antibody (ANCA) –> inappropriate activation of neutrophils