Nephritic Syndrome Flashcards
Nephritic Syndrome
Characterized by glomerular inflammation and bleeding
Limited proteinuria
Oliguria and azotemia
Periorbital edema (due to salt and fluid retention
Hypertension
RBC casts (casted in the shape of a tubule
Biopsy of nephritic syndromes
Hypercellular inflamed glomeruli
Immune complex deposition –> activates complement
C5a attracts neutrophils –> cause damage
PSGN
Arises 2-3 wks after group A beta-hemolytic Strep
Need to carry the M protein virulence factor to cause this
Classic presentation of PSGN
Hematuria Oliguria Hypertension Periorbital edema Usually seen in children, but may occur in adults
Biopsy of PSGN
Hypercellular, IC deposition
Sub-EPITHELIAL hump
Tx of PSGN
Supportive- deposits usually just pass through
May progress to renal failure (RPGN)
Rapidly progressive GN (RPGN)
Progresses rapidly to renal failure
Crescents in Bowman Space- that is composed of FIBRIN and MACROPHAGES (inflammatory debris- not collagen)
Immunofluorescence of RPGN
Linear: Abs against collage in GBM and alveoli (Goodpastures- classically in young adult male)
Granular: PSGN and Diffuse proliferative (SUB-ENDOTHELIAL deposits) and IgA nephropathy
Diffuse proliferative GN
Most common renal disease associated with SLE (if nephritic); if nephrotic with SLE: membranous
Negative IF (pauci-immune)
Perform ANCA
c-ANCA: Wegener (looks like Goodpastures but also has SINUSITIS)
p-ANCA: Churg-Strauss (eosinophilic) & microscopic polyangiitis
IgA nephropathy
Most common
IgA deposition in the mesangium (granular)
Episodic microscopic hematuria with RBC casts; usually follows mucosal infections (when more IgA is being produced)
Alport Syndrome
Inherited defect in Type IV collagen; most commonly X-linked dominant
Thinning and splitting of GBM
Isolated hematuria, hearing loss, and ocular disturbance
FH is a key component
