nephritic syndrome Flashcards
what are the features of nephritic syndrome/acute glomerulonephritis?
haematuria (macro/micro) + red cell casts
proteinuria-? oedema esp periorbital
HTN
oliguria + progressive renal impairment
what are the causes of nephritic syndrome?
proliferative/post-streptococcal
crescentic/RPGN- rapidly progressive glomerulonephritis
what are the features of proliferative/post-streptococcal glomerulonephritis?
young child develops malaise + nephritic syndrome
with smoky urine 1-2 weeks after sore throat/skin infx
raised ASOT (anti-streptoccal antibody titres)
low C3
what is the biopsy result of proliferative/post streptococcal glomerulonephritis?
IgG + C3 deposition
what is the management of proliferative/post streptococcal glomerulonephritis?
supportive
what is the prognosis of proliferative/post streptococcal glomerulonephritis?
95% children recover fully
minority develop RPGN- rapidly progressive glomerulonephritis
what is crescentic/RPGN?
most aggressive GN which can lead to ESRF in days
what are the different types of crescentic/RPGN?
type 1- anti-GBM (good pastures) 5%
type 2- immune complex deposition 45%
type 3- pauci immune 50%
what is anti-GBM/good pastures?
antibodies to NC domain of collagen 4
what are the features of anti-GBM/good pastures?
haematuria
haemoptysis
what are the CXR findings of antiGBM/good pastures?
infiltrates
what is the treatment of antiGBM/goodpastures?
plasmapheresis
immunosuppression
what are immune complex deposition?
complication of any immune complex deposition
berger’s, post-streptococcus, endocarditis, SLE
what does cANCA positive in pauci immune suggest?
wegener’s
what does pANCA positive in pauci immune suggest?
microscopoic polyangiitis
churg-strauss
even if ANCA+ may still be idiopathic if no features of systemic vasculitis
