Glomerulonephritis Flashcards
define anti-GBM disease (Goodpasture’s Syndrome)
a genetic autoimmune condition caused by a Type II antigen-antibody reaction
risk factors in Goodpastures Syndrome
genetics (HLA-DRB1)
smoking
infection
occupational exposure to organic solvents or metal dusts
clinical features of Goodpastures Syndrome
pyrexia nausea + vomiting chest pain haemoptysis haematuria hypertensions oedema
investigations of Goodpasture’s Syndrome
renal or lung biopsy
bloods (FBC, U+Es, ESR, complement and antinuclear antibodies)
CXR
management of Goodpastures Syndrome
high dose oral prednisolone or cyclophosphamide
plasmapheresis
indications for dialysis
Acidosis (pH <7.2) Electrolyte imbalance (persistent hyperkalaemia >7) Intoxication Oedema (refractory to pulmonary) Uraemia (pericarditis or encephalopathy)
define IgA neuropathy
a type of glomerulonephritis characterised by IgA deposition in the mesangium
clinical features of IgA neuropathy
gross or microscopic haematuria
recent URTI (12-72hrs)
hypertension
investigations of IgA neuropathy
MSSU for urinalysis and MC&S
bloods (FBC, U+Es and cultures if fever present)
renal biopsy
urinalysis findings in IgA neuropathy
blood +/- protein
RBCs (dysmorphic)
WBCs (neutrophils)
associated casts
microscopy findings of biopsy in IgA neuropathy
granular IgA and C3 deposits in sub-endothelium of glomerulus
management of IgA neuropathy
monitor and optimise fluid balance
ACE/ARBs
corticosteroids
microscopy findings of biopsy in Goodpastures Syndrome
linear IgG and C4 deposits in the basement membrane
define post-streptococcal glomerulonephritis
a type of glomerulonephritis occurring 1-2wks following a streptococcal throat infection or 2-6wks following streptococcal skin infection
causes of post-streptococcal glomerulonephritis
strains of group A β-haemolytic streptococci
