Nephritic Syndromes

Question 1

MPA - Microscopic Polyangitis

Answer 1

p-ANCA (MPO)
ILD in 7%
no granulomas on bx
a/w nec GN and pul haemorrhage

Question 2

GPA - Granulomatous Polyangitis

Answer 2

c-ANCA (pR3)
granulomas on bx
a/w upper airway sx - tracheal narrowing, scleritis, sinusitis

Question 3

EGPA - Eosinophilc Granulomatosis with Polyangitis

Answer 3

rare
can have p-ANCA or ANCA -ve
IgE
Eosinophilia
A/w Asthma
Can p/w mono neuritis, GIsx

Question 4

Mx of pauci immune GN

Answer 4

Cyclo OR Ritux, plus steroids

Relapse - use alternate agent

Maintenance - Aza

Pul haemorrhage –> PLEX

Question 5

IgA Nephropathy

• CF
• RF
• indications for bx

Answer 5

• hematuria, flank pain, fever, sympharyngitic infection
• a/w liver disease, HIV, coeliac disease, MCTD

Bx if (a/w poor prognosis)

• proteinuria >1g
• elevated Cr
• new HTN

Question 6

IgA Nephropathy

• Prognostic marker
• Mx

Answer 6

Poor prognosis a/w

• proteinuria >1g
• elevated Cr
• new HTN
• MEST-c on bx

Mx

• conservative
• ACEi
• steroids IF proteinuria >1g after 3-6m

Question 7

Post infectious GN

organism
RF
Patho

Answer 7

molecular mimicry - C3 and IgA deposits

RF - DM, Heart valve, IVDU

Organism: Strep (developing), Staph (developed)

Question 8

Anti-GBM (Goodpasture’s)

Patho
CF
Mx

Answer 8

Patho
-IgG + C3 dip along GBM +/- lung capillaries due to auto Ab

CF - RPGN, pul haemorrhage

Mx - PLEX, Steroids, Cytotoxcis

Question 9

Lupus nephritis

Indications for treatment

Answer 9

Stage 3 or 4

-treat with steroids +/- MMF