Mixed nephretic & nephrotic + other glomerular diseases

Question 1

Mesangiocapillary glomerulonephritis (membranoproliferative) (MCGN) 3 subtypes ?

Answer 1

Type 1 MCGN --> mesangial proliferation with subendothelial immune desposition + splitting capillary basement membrane
Type 2 (renal transplant patients) --> mesangial proliferation with electrodense linear intramembranous deposits
Type 3 --> features of both type 1 & 2

Question 2

Lupus nephritis (SLE)

Answer 2

immune deposits glomeruli & mesangium
different classes based on histology
Treat: type 1 no specific + type 2 benign course + type 3&4 steroids, cyclophosphamide

Question 3

Cryoglobulinaemic renal disease + 3 types

Answer 3

immunoglobulins + complement reversibly deposit
type 1 –> cryoprecipitable immunoglobulin
type 2 –> monoclonal IgM bound to IgG –> hep C associated
type 3 –> polyclonal IgM bound to IgG

Question 4

Henoch-Schönlein syndrome (purpura)

Answer 4

skin rash, abdominal colic, joint pain, glomerulonephritis
focal segmental proliferative GN, mesangial proliferation, crescents sometimes
IgA deposition
Steroids do NOT help

Question 5

Fabry’s disease

Answer 5

lysosomal storage disease

glycosphingolipis accumulate in podocytes –> CKD

Question 6

Sickle nephropathy

Answer 6

Sickle disease or trait complicated by papillary sclerosis or necrosis, nephrogenic diabetes insipidus, acidosis

Question 7

Glomerulopathy associated with pre-eclampsia

Answer 7

pre-eclampsia patients with hypertension and proteinuria, disappears after delivery
marked endothelial swelling + obliteration capillary