Norton2 Flashcards
Pauci-immune. No anti-GBM abs or immune complexes. Circulating ANCA.
Light microscopy > crescents.
See nothing on Immunofluorescence.
EM > ruptures in GBM
Rapidly progressive (crescent) glomerulonephritis - type 3
Hematuria and RBC casts in urine. Mild proteinuria, edema, HTN. Mild may resolve. Severe may progress to severe oliguria.
Rapidly progressive (crescent) glomerulonephritis
Treatment includes steroids and cytotoxic agents. For goodpastures you want to do ____________
Rapidly progressive (crescent) glomerulonephritis. Plasmapheresis
Hemoptysis and pulmonary hemorrhage
Goodpastures - Rapidly progressive (crescent) glomerulonephritis type one
Many pts progress to dialysis and need a transplant
Rapidly progressive (crescent) glomerulonephritis
Microscopic polyangiitis ________ ANCA
MPO
Wegners ____ ANCA
PR3
Anti-nuclear abs
Lupus
Anti GBM abs
Goodpastures
Increased permeability of BM (slit diaphragm not holding in proteins). Urinary loss of plasma proteins
Nephrotic syndrome
Proteinuria (>3.5 grams/day), hypoalbuminemia, edema, hyperlipidemia, and lipiduria
Nephrotic syndrome
Lipiduria
Fat in urine
Need to do a 24 hour urine collection to measure proteinuria
Nephrotic syndrome -
Immune complex deposition.
Light microscopy > crescents.
Immunofluorescence > granular immune complex deposits.
EM > ruptures in GBM and deposits
Rapidly progressive (crescent) glomerulonephritis - type two
Common cause of nephrotic syndrome in adults
Membranous nephropathy
Immune complex mediated and usually indolent
Membranous nephropathy
Primarily idiopathic (85% cases) but can be secondary to drugs, malignancies, lupus, and infections (antigens related to underlying disease present in immune complexes)
Membranous nephropathy
Light microscopy > normal glomeruli or diffuse thickening of glomerular capillary wall
Membranous nephropathy
Immunofluorescence > granular IgG and C3.
EM > spikes and domes of immune complex deposits between GBM and epithelial cells. Effaced foot processes
Membranous nephropathy
> 60% have persistent proteinuria and 40% develop renal insufficiency
Membranous nephropathy
Spontaneous remission occurs in women and pts with less proteinuria
Membranous nephropathy
Insidious onset of nonselective proteinuria
Membranous nephropathy
Hematuria, mild HTN. Can progress to ^ glomerulosclerosis, ^ serum Cr, and ^ HTN
Membranous nephropathy
