Nephritic Syndrome (20-3) Flashcards
Nephritic Syndrome includes _____ in the glomeruli
Inflammation
What are the 4 signs of Nephritic Syndrome?
- Proteinuria < 3.5 g/day
- Hematuria
- New onset HTN
- Azotemia
What are the 4 signs of Nephritic Syndrome?
- Proteinuria < 3.5 g/day
- Hematuria
- New onset HTN
- Azotemia
All of the diseases discussed in this deck can cause?
Nephritic Syndrome and/or Rapidly Progressive Glomerulonephritis
Post-Infectious Glomerulonephritis is most commonly due to infections with what bacteria and where and in who?
Streptococci of the pharynx/skin in children
What types of streptococci are the most common causes of Post-Infectious Glomerulonephritis?
Group A beta-hemolytic types 12, 4, 1
Post-Infectious Glomerulonephritis involves the proliferation of glomerular cells with leukocyte influx. Where do these complexes deposit?
Subepithelial humps
How does Post-Infectious Glomerulonephritis look on immunofluorescence?
Granular
– in situ immune complex formation
What occurs with Rapidly Progressive Glomerulonephritis (RPGN)?
Rapid loss of renal function
- -> oliguria and nephritic syndrome signs
- -> renal failure
What is a hallmark of RPGN?
Crescents in the glomeruli
– epithelial cells + leukocytes
What is 1 Anti-GBM antibody disease that can cause RPGN/Nephritic Syndrome?
Goodpasture Syndrome
What are the symptoms of Goodpasture Syndrome and in what patients?
Pulmonary hemorrhage + renal failure in young men
How will Goodpasture Syndrome appear on immunofluorescence?
Linear
– Anti-GBM antibodies
Goodpasture syndrome involves Anti-GBM antibodies that are specific to what portion?
Non-collagenous alpha 3 unit of collagen 4
What are the 3 immune complex deposition diseases that can cause RPGN/Nephritic Syndrome?
- Lupus Nephritis
- Henoch-Schonlein Purpura
- IgA Nephropathy
What are the 3 immune complex deposition diseases that can cause RPGN/Nephritic syndrome?
- Lupus Nephritis
- Henoch-schonlein purpura
- IgA Nephropathy
What antibodies classify Lupus Nephritis type IV?
Anti-dsDNA
Anti-smith
What is a hallmark of Lupus Nephritis?
Wire loop
= subendothelial deposits that cause circumferential thickening of capillary wall
What is a hallmark of Lupus Nephritis?
Wire loop
= subendothelial deposits that cause circumferential thickening of capillary wall
What population of people are usually affected by Henoch-schonlein purpura?
Children
What are the symptoms in children with Henoch-Schonlein Purpura?
Purpura of the legs, arms, butt
Abdominal pain and GI bleed
Athralgias and renal abnormalities
What are the symptoms in children with Henoch-Schonlein Purpura?
Purpura of the legs, arm, butt
Abdominal pain with GI bleed
Athralgias and renal abnormalities
If Henoch-schonlein purpura presents in adults, what symptoms will be more severe?
Renal symptoms
With Henoch-Schonlein purpura, what does the child of a background of and a history of?
Background of atopy
History of recent URI
What is hallmark of Henoch-Schonlein purpuar?
IgA deposits in Mesangium
IgA deposits in the mesangium could indicate what 2 immune complex deposition diseases?
Henoch-Schonlein Purpura
IgA Nephropathy
IgA nephropathy is the most common cause of Nephritic syndrome/RPGN. Where will IgA be deposited?
Mesangium
What is a recurrent symptom of IgA Nephropathy?
Recurrent hematuria
What types of diseases can IgA nephropathy present with?
Celiac disease
Liver disease
Abnormal IgA synthesis
Besides IgA deposits in the mesangium with IgA nephropathy, what else will be deposited?
C3
Properdin
What is a Pauci-Immune cause of Nephritic Syndrome/RPGN?
Granulomatosis with Polyangiitis
What marker will be (+) with Granulomatosis with Polyangiitis?
PR3 - ANCA
What usually causes Granulomatosis with Polyangiitis?
T cell hypersensitivity to an inhaled antigen
What are the general symptoms of Granulomatosis with Polyangiitis?
Granulomas and vasculitis of the respiratory tract
What is RPGN?
Rapid loss of renal function
- -> oliguria and signs of nephritic syndrome
- -> renal failure
