Glomerulonefrite Pós Infecciosa

Question 1

História natural da GNPE e sua etiologia em crianças:

Answer 1

Question 2

Etiologia da GN pós infecciosa em adultos:

Answer 2

Question 3

Epidemiologia da GNPE:

Answer 3

Question 4

Agente etiológico mais comum da GNPE:

Answer 4

SPGN is an immune complex-mediated glomerulonephritis that follows an infection by a nephritogenic strain of group A beta-hemolytic
Streptococcus
of the pharynx or skin. The interval between pharyngitis and the developmentof APSGN is approximately 1 to 2 weeks. In contrast, the latency period between a skin infection and ASPGN is 3to 6 weeks

Question 5

Dois quadros clínicos principais da GNPE na infância:

Answer 5

Both severehypertension and renal failure can occur as part of a rapidly progressive glomerulonephritis. After initial assessment,the most important diagnostic test is measurement of complement component 3 (C3) to confirm the presence of
hypocomplementemia
, which occurs in more than 90% of cases

Question 6

Mecanismo de lesão glomerular na GNPE:

Answer 6

Question 7

Qual a causa mais comum de Síndrome Nefrítica na infância?

Answer 7

Question 8

Como fazer o Dx da GNPE?

Answer 8

As noted previously, the characteristic laboratory feature of ASPGN is hypocomplementemia, which typicallyfeatures depressed C3 and normal C4 values. The differential diagnosis of hypocomplementemic glomerulonephritisconsists of membranoproliferative glomerulonephritis (MPGN) in a child who has disease limited to the kidney andsystemic lupus erythematosus in a child who has multisystem disease. Rarer causes of hypocomplementemicglomerulonephritis include subacute bacterial endocarditis, shunt nephritis (in patients who have ventriculoatrialshunts), and essential mixed cryoglobulinemia.

Question 9

Fisiopatologia da GNPE:

Answer 9

Question 10

Tto da GNPE:

Answer 10

Question 11

Prognóstico da GNPE:

Answer 11

The key follow-up test is a repeat measurement of C3, which usually normalizes within 8 weeks. Patients in whomdepression of C3 persists after 12 weeks may require a renal biopsy to rule out MPGN. The prognosis of ASPGN isexcellent. Gross hematuria and hypertension usually resolve within a few weeks and proteinuria within a fewmonths. Microscopic hematuria may persist for 1 to 3 year

Question 12

Critérios para realizar a Bx em pacientes GNPE:

Answer 12

Question 13

Achado na Bx característico da GNPE:

Answer 13

Question 14

Achado e Dx a seguir:

Answer 14