Glomerulonephritis (2)

Question 1

What occurs here?

What is Interstitial nephritis?

What is Glomerulosclerosis?

Answer 1

➊ Inflammation causing damage to glomerulus, basement membrane and capillaries

➋ Inflammation of the space between the cells and tubules

➌ Scarring of the glomerulus, which can be due to GN, obstructive uropathy, and focal segmental glomerulosclerosis

Question 2

What are the causes?

What are its clinical features?

What are most types of GN treated with?

Answer 2

➊ • Infection e.g. GA Strep, Hep B and C
• Systemic inflammation e.g. SLE, RA
• Drugs e.g. NSAIDs
• Metabolic disorders e.g. DM, HTN
• Malignancy

➋ • Haematuria
• Oliguria
• Proteinuria (< 3g/24hrs, which is the hallmark after which it becomes nephrotic)
• Oedema
• HTN

➌ Steroids and ACEi/ARBs (controls BP and decreases proteinuria)

Question 3

When does IgA Nephropathy typically occur?
→ Which type of hypersensitivity reaction is this?
→ What does its histology show?

What does the histology of Membranous GN show?

When does Post-streptococcal GN typically occur?

What’s another name for Goodpastures Syndrome?
→ What occurs in it?
→ What may they present with as a result?
→ How is it treated?

Answer 3

➊ Days post-infection
→ Type 3 (immune complexes)
→ IgA deposits and glomerular mesangial proliferation

➋ IgG and complement deposits on the basement membrane

➌ Weeks post-infection e.g. tonsillitis or impetigo

➍ Anti-GBM (glomerular basement membrane) Disease
→ Anti-GBM attack kidneys and lungs, causing glomerulonephritis and pulmonary haemorrhage
→ Acute kidney failure and Haemoptysis
→ • Removing any circulating antibody - Plasmapheresis
• Immunosuppression to stop further production of antibodies - High-dose steroids and Cyclophosphamide