Nephritic Syndrome

Question 1

Nephritic Syndrome

Answer 1

1. RBC casts and dysmorphic RBC in urine
2. periorbital edema, HTN (bc of salt retention)
3. Oliguria/azotemia
   in general- glomerular inflammation with bleeding (hypercellular (high neutrophils?) inflamed glomeruli)

Question 2

What is an important component of the inflammation seen in Nephritic syndromes?

Answer 2

Immune Complex deposition.

This activates complement, and C5a which attracts neutrophils that mediate damage

Question 3

Post strep glomerulonehpritis (usually seen in children)

Answer 3

1. Group A, beta hemolytic strep (strep pyogenes)
2. 2-3 weeks after infection
3. cola colored urine (hematuria)
4. periorbital edema and HTN
5. subepithelial humps on EM
6. usually self resolves

Question 4

RPGN (rapidly progressive glomerulonephritis)

IF findings:

Answer 4

1. Linear (anti basement antibody)–Goodpastures
2. Granular (immune complex)–Diffuse proliferative glomerulonephritis (lupus nephritis–most commonly seen in lupus)—sub endothelial deposits
3. Pauci Immune (neg IF)–Wegener’s, Churg strauss, microscopic polyangiitis.

Question 5

IgA nephropathy

Answer 5

1. IgA IC deposition in mesangium
2. following mucosal infections
3. episodic gross hematuria (during infections bc IgA is increased)–especially during childhood

Question 6

Alport Syndrome

Answer 6

1. Defect in Type IV collagen
2. X linked
3. thinning and splitting of BM
4. hematuria, hearing loss, ocular disturbances