nephritic Flashcards
renal limited GN
IgA Anti-GBM MPGN ANCA C3
Systemic GN
Henoch-Schonlein - associated with IgA
Goospasture - associated with antiGBM
Lupus nephritis - associated with ANA
ANCA -
Nephritic syndrome (4)
Hematuria (RBC dysmorphic and RBC casts)
proteinuria
elevated Cr
Elevated BP
Workup
3
serum
biopsy
urinalysis
GN associated with aggressive disease? (3)
RPGN
Crescentric
PR syndrome
RPGN
Creatinine?
serum creatinine doubles or GFR falls by 50% within few days - 3 months
RPGN
Usually associated wtih ?
Anti gbm
ANCA
Lupus
RPGN
therapy
more aggressive
cytotoxics / plasma exchange
Crescentric GN
capillary wall?
rupture
Crescentric GN
Associated wtih
Anti gbm
lupus
anca
Crescentric GN
treatment
aggressive
cytotoxics
plsama exhcnage
Which Glomerulonephritis are associated with immune complex deposits? (2)
lupus
MPGN
Which GNs are associated with antibodies for renal antigens
anti gbm
maybe lupus
which GNs are associated wtih other causes of inflammation within the glomeruli?
vasculitis (ANCA)
Hemolytic uremic syndrome
C3 glomerulopathy
where can immune complexes deposity?
mesangial
subendo
subepi
intramembranous
where do glomerular immune complexes come from?
antibodies to glomerular antigens that are capped and shed
antibodies to extraglomerular antigens (infection/cancer.drug)
idiopathic
mesangial immune deposits
clinical picture
hematuria - low grade proteinuria - usually not as severe
sub-endo immune complexes
hematuria / RBC casts / elevate creatinine / proteinuria
necrotizing lesions / crescentirc disease
hematuria / rbc casts / RPRF
IgA nephropathy
cause?
mesangial IgA deposits with mesangial expansion - aberrant glycosylation of IgA1
most common cause of GN worldwide
IgA nephropathy presenation
hematuria +/- proteinuria
episodes of hematuria may be synphayngetic (w/in days of URI)
IgA course?
slowly progressive
30% remit
30% esrd
40% mid
IgA treat?
ACE -I
Prednisone
lupus nephritis
affects what % lupus?
50%
lupus nephritis
presentation?
variable
between patients and within patient overtime
lupus nephritis
cuase?
immune complex deposits mesangium (hematuria) I / II subendo (nephritic) III / IV subepi (nephrotic) V scarring (VI)
ANTI-GBM
CAUSE
Auto antibodies to NC1 domain of alpha3 chain of type IV colagen
renal or PR
AntiGBM
presentaition
often causes crescentric / necrotizing GN and RPGN