Major Glomerulonephritides table 20-5

Question 1

Disease: Postinfectious glomerulonephritis

1. Most Frequent clinical presentation
2. Pathogenesis
3. Glomerular pathology by
   
   1. light microscopy
   2. flourescence micropscopy
   3. electron microscopy

Answer 1

1. Most Frequent clinical presentation: Nephritic syndrome
2. Pathogenesis Immune complex mediated: circulating or planted antigen
3. Glomerular pathology by
   
   1. light microscopy: Diffuse endocapillary proliferation; leukocytic infiltration
   2. flourescence micropscopy: Granular IgG and C3 in GBM and mesangium; Granular IgA in some cases
   3. electron microscopy: Primarily subepithelial humps; subendothelial deposits in early disease stages.

Question 2

Disease: Goodpasture syndrome

1. Most Frequent clinical presentation
2. Pathogenesis
3. Glomerular pathology by
   
   1. light microscopy
   2. flourescence micropscopy
   3. electron microscopy

Answer 2

1. Most Frequent clinical presentation: Rapidly progressive glomerulonephritis
2. Pathogenesis : Anti-GBM COL4-A3 antigen
3. Glomerular pathology by:
   
   1. light microscopy:
      
      1. Extracapillary proliferation with crescents
      2. necrosis
   2. flourescence micropscopy:
      
      1. Linear IgG and C3
      2. fibrin in crescents
   3. electron microscopy :
      
      1. No deposits
      2. GBM disruptions
      3. fibrin

Question 3

Disease: Chronic glomerulonephritis

1. Most Frequent clinical presentation
2. Pathogenesis
3. Glomerular pathology by
   
   1. light microscopy
   2. flourescence micropscopy
   3. electron microscopy

Answer 3

1. Most Frequent clinical presentation: Chronic renal failure
2. Pathogenesis; Variable
3. Glomerular pathology by:
   
   1. light microscopy: Hyalinized glomeruli
   2. flourescence micropscopy: Granular or negative
   3. electron microscopy: none

Question 4

Disease: Membranous nephropathy

1. Most Frequent clinical presentation
2. Pathogenesis
3. Glomerular pathology by
   
   1. light microscopy
   2. flourescence micropscopy
   3. electron microscopy

Answer 4

1. Most Frequent clinical presentation: Nephrotic syndrome
2. Pathogenesis : In situ immune complex formation; PLA 2-R antigen in most cases of primary disease mostly unknown
3. Glomerular pathology by:
   
   1. light microscopy: Diffuse capillary wall thickening
   2. flourescence micropscopy: Granular IgG and C3; diffuse
   3. electron microscopy : Subepithelial deposits

Question 5

Disease: Minimal change disease

1. Most Frequent clinical presentation
2. Pathogenesis
3. Glomerular pathology by
   
   1. light microscopy
   2. flourescence micropscopy
   3. electron microscopy

Answer 5

1. Most Frequent clinical presentation: Nephrotic syndrome
2. Pathogenesis : Unknown; loss of glomerular polyanion; podocyte injury
3. Glomerular pathology by
   
   1. light microscopy: Normal; lipid in tubules
   2. flourescence micropscopy: Negative
   3. electron microscopy : Loss of foot processes; no deposits

Question 6

Disease: Focal segmental glomerulosclerosis

1. Most Frequent clinical presentation
2. Pathogenesis
3. Glomerular pathology by
   
   1. light microscopy
   2. flourescence micropscopy
   3. electron microscopy

Answer 6

1. Most Frequent clinical presentation: Nephrotic syndrome; nonnephrotic proteinuria
2. Pathogenesis:
   
   1. Unknown
   2. Ablation nephropathy
   3. Plasma factor (?); podocyte injury
3. Glomerular pathology by
   
   1. light microscopy: Focal and segmental sclerosis and hyalinosis
   2. flourescence micropscopy: Focal; IgM + C3 in many cases
   3. electron microscopy: Loss of foot processes; epithelial denudation

Question 7

Disease: Membranoproliferative glomerulonephritis (MPGN) type I

1. Most Frequent clinical presentation
2. Pathogenesis
3. Glomerular pathology by
   
   1. light microscopy
   2. flourescence micropscopy
   3. electron microscopy

Answer 7

Disease

1. Most Frequent clinical presentation: Nephrotic/nephrotic syndrome
2. Pathogenesis: immune complex
3. Glomerular pathology by
   
   1. light microscopy: Mesangial proliferative or membranoproliferative patterns of proliferation; GBM thickening; splitting
   2. flourescence micropscopy: IgG ++ C3; C1q ++ C4
   3. electron microscopy: Subendothelial deposits

Question 8

Disease: Dense-deposit disease (MPGN type II)

1. Most Frequent clinical presentation
2. Pathogenesis
3. Glomerular pathology by
   
   1. light microscopy
   2. flourescence micropscopy
   3. electron microscopy

Answer 8

1. Most Frequent clinical presentation: Hematuria
   Chronic renal failure
2. Pathogenesis: Autoantibody; alternative complement pathway
3. Glomerular pathology by
   
   1. light microscopy:Mesangial proliferative or membranoproliferative patterns of proliferation; GBM thickening; splitting
   2. flourescence micropscopy: C3; no C1q or C4
   3. electron microscopy: Dense deposits

Question 9

Disease: IgA nephropathy

1. Most Frequent clinical presentation
2. Pathogenesis
3. Glomerular pathology by
   
   1. light microscopy
   2. flourescence micropscopy
   3. electron microscopy

Answer 9

1. Most Frequent clinical presentation: Recurrent hematuria or proteinuria
2. Pathogenesis: Unknown
3. Glomerular pathology by
   
   1. light microscopy: Focal mesangial proliferative glomerulonephritis; mesangial widening
   2. flourescence micropscopy: IgA ± IgG, IgM, and C3 in mesangium
   3. electron microscopy: Mesangial and paramesangial dense deposits

Question 10

Disease

1. Most Frequent clinical presentation
2. Pathogenesis
3. Glomerular pathology by
   
   1. light microscopy
   2. flourescence micropscopy
   3. electron microscopy

Answer 10

Disease

1. Most Frequent clinical presentation
2. Pathogenesis
3. Glomerular pathology by
   
   1. light microscopy
   2. flourescence micropscopy
   3. electron microscopy

Question 11

Disease

Most Frequent clinical presentation

Pathogenesis

Glomerular pathology by light microscopy, flourescence micropscopy, electron microscopy

Answer 11

Disease

Most Frequent clinical presentation

Pathogenesis

Glomerular pathology by light microscopy, flourescence micropscopy, electron microscopy

Question 12

Disease

Most Frequent clinical presentation

Pathogenesis

Glomerular pathology by light microscopy, flourescence micropscopy, electron microscopy

Answer 12

Disease

Most Frequent clinical presentation

Pathogenesis

Glomerular pathology by light microscopy, flourescence micropscopy, electron microscopy

Question 13

Disease

Most Frequent clinical presentation

Pathogenesis

Glomerular pathology by light microscopy, flourescence micropscopy, electron microscopy

Answer 13

Disease

Most Frequent clinical presentation

Pathogenesis

Glomerular pathology by light microscopy, flourescence micropscopy, electron microscopy

Question 15

light microscopy: Diffuse capillary wall thickening

flourescence micropscopy: Granular IgG and C3; diffuse

electron microscopy : Subepithelial deposits

Answer 15

Membranous nephropathy