Glomerulonephritis Disease Flashcards
define IgA neuropathy
a type of glomerulonephritis characterised by IgA deposits within the glomeruli mesangium
cause of IgA neuropathy
increased synthesis of IgA that forms immune complexes easily trapped within the mesangium, causing build up and responses that trigger damage
clinical features of IgA neuropathy
gross or microscopic haematuria
hypertension
facial + leg oedema
recent respiratory illness
investigations of IgA neuropathy
bloods (FBC, U+Es, RFTs, creatinine)
urinalysis + MC&S
renal biopsy with immunofluorescence staining
common findings on investigations in IgA neuropathy
urine: +ve RBC + protein + WBCs
biopsy: IgA +C3 deposits in granular pattern in basement membrane
conservative management of IgA neuropathy
monitor and optimise fluid balance
medical management of IgA neuropathy
ACE inhibitors and ARBs
indications for use of corticosteroids (e.g. prednisolone) in IgA neuropathy
severe inflammatory damage
rapidly declining kidney function
define post-streptococcal glomerulonephritis (post strep GN)
a type of glomerulonephritis commonly occurring 1-2wks following a strep throat infection
clinical features of post-strep GN
acute insidious onset of haematuria, oliguria, hypertension and periorbital oedema
previous streptococcal illness 1-6wks ago
investigations of post-strep GN
urinalysis MC&S
bloods (FBC, U+Es, and immunoglobulins)
renal biopsy
common findings on investigations of post-strep GN
biopsy: IgG and C3 subepithelial deposition
urine: +ve blood + protein
management of post-strep GN
supportive measures
define anti-glomerular basement membrane disease (Goodpastures)
a genetic autoimmune condition characterised by a combo of glomerulonephritis, alveolar haemorrhage and circulating anti-GBM antibodies
risk factors of goodpastures disease
genetics (HLA-DRB1) smoking exposure to organic solvents/hydrocarbons infection cocaine inhalation occupational exposure to metal dusts
clinical features of goodpastures disease
fluctuating fever nausea + vomiting weight loss chest pain + SOB oedema haematuria arthralgia
investigations of Goodpastures disease
bloods (FBC, U+Es, ESR, antinuclear antibodies and complement)
CXR
renal or lung biopsy
management of Goodpastures disease
plasmapheresis
high dose oral prednisolone or cyclophosphamide
requirements of renal transplant in Goodpastures disease
end stage renal disease
serum anti-GBM antibodies undetectable for 12 mnths
disease remission for 6mnths
define minimal change disease
a disease of the kidneys occurring due to minimal histological changes in the nephrons
clinical features of minimal change disease
facial swelling that spreads to oedema
nausea + vomiting
abdominal pain
lethargy
investigations of minimal change disease
urine dipstick
bloods (FBC, U+Es, LFTs)
management of minimal change disease
fluid restriction and ⬇️ salt intake
corticosteroids (prednisolone)
human albumin and furosemide
investigation findings in minimal change
+ve protein
define membranous glomerulonephritis
the most common type of glomerulonephritis in adults
causes of membranous glomerulonephritis
anti-phospholipase A2 antibodies
hepatitis B
malignancy
clinical features of membranous glomerulonephritis
oedema of face and legs
recurrent infections
fatigue
SOB
investigation findings of membranous glomerulonephritis
basement membrane thickening with subepithelial electron dense deposits
“spike and dome” appearance
investigations of membranous glomerulonephritis
bloods (FBC, LFTs, RFTs, lipid and coagulation screen)
urine dipstick
US KUB
CXR + AXR
management of membranous glomerulonephritis
ACE inhibitor or ARB
immunosuppression (corticosteroid + cyclophosphamide)
