Glomerulonephritis

Question 1

What is Glomerulonephritis?

Answer 1

A group of disorders causing glomerular damage leading to haematuria +/- proteinuria
Can cause AKI or renal failure

Question 2

How can Glomerulonephritis present?

Answer 2

Microscopic haematuria
Nephritic syndromes
Nephrotic syndromes

Question 3

What are some of the causes of Glomerulonephritis?

Answer 3

Idiopathic
Immune - SLE, Goodpastures, Vasculitis
Infection - HBV, HCV, Strep, HIV
Drugs - Penicillamine, Gold
Amyloidosis

Question 4

What is Penicillamine?

Answer 4

A chelting agent

Used to bind to other agents in the body and remove them eg excess copper in Wilson’s disease

Question 5

What bloods can be done in a patient with suspected Glomerulonephritis?

Answer 5

FBC
U+Es
ESR/CRP
C3/C4
Antibodies - ANA, dsDNA, ANCA, GBM
HBV + HCV serology

Question 6

What investigations can be performed on the urine of a patient with suspected Glomerulonephritis?

Answer 6

Dipstick (Proteinuria, Haematuria)
PCR
Urine Microscopy, Culture + Sensitivity
Bence Jones proteins

Question 7

What are Bence Jones proteins?

Answer 7

Monoclonal immunoglobulin light chains found in urine and plasma of patients with myeloma or other lympoid malignancies

Question 8

What imaging can be done on a patient with suspected Glomerulonephritis?

Answer 8

Renal ultrasound +/- Biopsy

CXR - Show infiltrates in some disorders eg Goodpastures, Wegners

Question 9

What is the general management of a patient with Glomerulonephritis?

Answer 9

Refer to nephrologist

Treat any hypertension aggressively include ACEi and accessory renal arteries