Nephritis syndrome Flashcards
Nephritic syndrome
Inflammatory process
When involves glomeruli, leads to hemturiaand RBC casts in urine.
Associated with azotemia, oliguria, HTN (due to salt retention). and proteinuria (<3.5g/day)
Nephritic syndrome list
1) acute post strep glomerulonephritis
2) rapidly progressive (crescentic) glomerulonephritis (RPGN)
3) diffuse proliferative glomerulonephritis (DPGN)
4) Berger’s disease (IgA nephropathy)
5) Alport syndrome
Acute post strep glomerulonephritis
LM= glomeruli enlarged and hypercellular, neutrophils, lumpy-bumpy appearance
EM= subepithelial immune complex (IC) humps
IF=granular appearnce due to IgG, IgM, and C3 deposit along GBM and mesangium
Most freq seen in children
Peripheral and perioirbital edema, dark urine, HTN
Resolves spontaneously
Rapidly progressive (crescentic) glomerulonephritis (RPGN)
LM and IF = crescent moon shape, crescents consist of fibrin and plasma protein (C3b) with glomerular parietal cells, monocytes, and macrophages
Poor prognosis, rapidly deteriorating renal function
Several disease result in this pattern
1) goodpasture
2) granulomatosis with polyangiitis
3) microscopic polyangiitis
RPGN: goodpasture
Type II hypersensitivity;
Ab to GBM and alveolar basement membrane
thus linear IF
Hematuria/hemoptysis
RPGN: Granulomatosis with polyangiitis (wegner’s)
c-ANCA
RPGN: microscopic polyangiitis
p-ANCA
Diffuse proliferative glomerulonehpritis (DPGN)
Due to SLE or MPGN
LM=wire looping of capillaries
EM=subendothelial and sometimes intramembranous IgG based ICs often with C3 deposition
IF=grandular
Most common cause of death in SLE.
SLE and MPGN can present as nephrotic syndrome and nephritic syndrome concurrently
Berger’s disease (IgA nephropathy)
Related to Henoch-Schonlein purpura
LM=mesangial proliferation
EM=mesangial IC deposit
IF=IgA based IC deposits in mesangium
Often presents/flares with a URI or acute GI
Alport syndrome
Mutation in type IV collagen
Split basement, X linked
Glomerulonephritis, deafness, and less commonly, eye problems.
