Nephritic Syndrome Flashcards
Signs/Sx of Nephritic Syndrome
hematuria
limited proteinuria (<3.5 g/day)
azotemia
oliguria
periorbital edema
Bx of nephritic syndrome
hypercellular, inflamed glomeruli
Post-Strep Glomerulonephritis
after what infection?
group A β-hemolytic strep
impetigo or pharyngitis
Virulence factor causing
post-strep glomerulonephritis
M-protein
(same as in rheumatic heart disease)
Histological findings in
post-strep glomerulonephritis
subepithelial “humps” on H&E
begin to form sub-endothelial, but work way out into interstitium where they disappear
Difference(s) between hypersensitivity reaction in rheumatic fever and post-strep glomerulonephritis
both create antibodies against M-protein of Strep
but
rheumatic fever: type II hypersensitivity of these antibodies to meromyocin in heart
post-strep glomerulonephritis: type III hypersensitivity, deposits found in sub-epithelial layer of glomerulus
Hallmark of rapidly progressive glomerulonephritis
crescents!
fibrin and macrophages
Crescents are made up of
fibrin and macrophages
Crescents are indicitive of
rapidly progressive glomerulonephritis
fibrin and macrophages!
Crescents are located
in Bowman’s space
IgA nephropathy
basic pathology
IgA created each time patient has mucosal infection
IgA also gets released into blood
deposits in mesangium
each time infection occurs, more gets deposited
gets worse with each subsequent infection
Deposits in IgA nephropathy
multimers of IgA
not normal monomeric IgA like sIgA
mesangium
Alport Syndrome
basic pathology
X-linked type IV collagen defect
in glomerular basement membrane
results in thinning and splitting of glomerular BM
also possible: sensory hearing loss, occular disturbances
12 y/o male presents with hematuria to the ER. no recent Hx of other illnesses, but recently failed hearing test at school. his mother also mentions that he a mild strabismus as a child.
what is the defect
Alport syndrome
X-linked type IV collagen
affects glomerular basement membrane, sensory hearing, and ocular disturbances
23 y/o female with recurrent episodes of gross hematuria. each time before episodes she has what sounds like a URI. pathology
IgA nephropathy
IgA formed in muscal infections
also in blood
IgA deposits more each time it is formed into
mesangium
