GLOMERULONEPHRITIS KEY FACTS Flashcards
How are most types of glomerulonephritis cases treated?
- Immunosuppresion e.g. with steroids
- B.P control by blocking the renin-angiotensin system (i.e. ACEI or ARBs)
What are the criteria for nephrotic syndrome?
- peripheral oedema
- proteinuria (more than 3g per 24 hours urine)
- serum albumin (less than 25g per litre)
- hypercholesterolaemia
What symptoms do a patient with nephrotic syndrome typically present with?
- oedema
- may notice frothy urine (proteinuria)
What does nephrotic syndrome predispose a patient to?
- Thrombosis
- Hypertension
- High cholesterol
What is the most common cause of nephrotic syndrome in kids?
What is the most common aetiology of this diagnosis?
Minimal change disease
Usually idiopathic
What is minimal change disease treated with?
Is it usually successful?
Minimal change disease is usually successfully treated with steroids
What is the most common cause of nephrotic syndrome in adults?
Focal segmental glomerulosclerosis
What is the most common cause of primary glomerulonephritis?
IgA nephropathy (a.k.a. Berger’s disease)
What is the most common cause of primary glomerulonephritis?
At what age does it usually present?
IgA nephropathy
Peak age at presentation is in 20s
What is the likely diagnosis if histology shows:
‘IgA deposits and glomerular mesangial proliferation’
IgA nephropathy (a.k.a. Berger’s disease)
What is the most common type of glomerulonephritis overall?
Membranous glomerulonephritis
What is the most common type of glomerulonephritis overall?
At what age does it usually present?
Membranous glomerulonephritis
There is a bimodal peak in age 20s and 60s
What is the most likely diagnosis if histology shows:
‘IgG and complement deposits on the basement membrane’
Membranous glomerulonephritis
What is the most common type of glomerulonephritis overall?
What are the possible aetiologies?
Membranous glomerulonephritis
The majority (70%) are idiopathic
But they can be secondary to…
- malignancy
- rheumatoid disorders
- drugs (NSAIDs)
A 27 year old patient presents with reduced urine output. On urine dipstick there is microscopic haematuria. A thorough history reveals he had tonsillitis 2 weeks ago.
Likely diagnosis?
Post streptococcal glomerulonephritis (a.k.a. diffuse proliferative glomerulonephritis)
Describe the typical presentation of an individual with post streptococcal glomerulonephritis?
Also state what else this disease is called.
a.k.a. diffuse proliferative glomerulonephritis
Patients are typically under 30 years old
It presents as:
- 1-3 weeks after a streptococcal infection (strep pyogenes) e.g. tonsillitis or impetigo
- they develop a nephritis syndrome
- there is usually a full recovery
A patient presents with AKI and haemoptysis.
What is your differential?
Goodpasture Syndrome
Briefly discuss the pathophysiology of Goodpasture Syndrome
Anti-GBM (glomerular basement membrane) antibodies attack the glomerulus and pulmonary basement membranes
This causes
- Glomerulonephritis
- Pulmonary haemorrhage
How might Goodpasture Syndrome present?
AKI
and
Haemoptysis
What is a possible complication of Goodpasture Syndrome?
Rapidly Progressive Glomerulonephritis
What is the diagnosis if histology shows:
‘crescentic glomerulonephritis’
Rapidly progressive glomerulonephritis
Briefly discuss the presentation and Tx outcome of rapidly progressive glomerulonephritis
It presents with a very acute illness with sick patients but it responds well to treatment
What histology results would you expect in a patient with IgA nephropathy?
IgA deposits and glomerular mesangial proliferation
What histology results would you expect in membranous glomerulonephritis?
IgG and complement deposits on the basement membrane
What histology results would you expect in someone with rapidly progressive glomerulonephritis?
Crescentic glomerulonephritis
