Nephritic Syndrome

Question 1

What is nephritic syndrome?

Answer 1

• Deposition of immune complexes in capillaries causes an inflammatory response and breakdown of capillaries
• RBC and WBCs pour through openings

Question 2

What is seen in nephritic syndrome?

Answer 2

• Proteinuria
• Haematuria
• Oliguria -> damage to glomerulus does not allow filtration
• Oedema -> more fluid retained

Can also see:
• Pyuria
• Sediments
• HTN -> lack of filtration

Question 3

What is post-streptococcal glomerulonephritis?

Answer 3

o Group A beta-haemolytic streptococci bacteria cause haemolysis of RBCs
o Causes a type III hypersensitivity reaction that becomes trapped in the GBM causing inflammation

Question 4

What can cause post-streptococcal glomerulonephritis?

Answer 4

Streptococcus pyogenes

Question 5

Who is commonly affected by post-streptococcal glomerulonephritis?

Answer 5

Children
• 6 weeks after impetigo (skin infection)
• 1-2 weeks after pharyngitis

Question 6

What is the prognosis of post-streptococcal glomerulonephritis?

Answer 6

• Normally resolves within 1 mnth
• Sometimes -> renal failure
• ¼ adults -> rapidly progressive glomerulonephritis -> renal failure

Question 7

What does light microscopy, electron microscopy and immunofluorescence show for post-streptococcal glomerulonephritis?

Answer 7

Light microscopy
o Glomerulus is enlarged and hypercellular

Electron microscopy
o Subepithelial deposits

Immunofluorescence
o Granular/starry sky appearance along GMB and mesangium

Question 8

What blood tests would you do for post-streptococcal glomerulonephritis?

Answer 8

• Anti-DNase B

* Decreased complement levels

Question 9

What is IgA nephropathy?

Answer 9

Haematuria occurring 1-3 days after upper respiratory infection or gastroenteritis

Question 10

What is the peak age of IgA nephropathy?

Answer 10

20s

Question 11

What does light microscopy and immunofluorescence show for IgA nephropathy?

Answer 11

Light microscopy
o Focal or diffuse mesangial proliferation and extracellular matrix expansion

Immunofluorescence
o Mesangial IgA deposits

Question 12

What is Alport’s Syndrome?

Answer 12

o X-linked recessive

o Accumulation of abnormal type IV collagen causes progressive degeneration of GBM

Question 13

What is Alport’s syndrome associated with?

Answer 13

• Sensorineural deafness

- Ocular abnormalities