Pathology of Nephritic Syndrome Flashcards
The presence of crescents correlates with ______ and carries a ______ prognosis.
RPGN; poor
What is cryoglobinemia?
Antibodies that precipitate in the cold and cause a small vessel vasculitis
Name 5 characterstics of nephritic syndrome.
- Reduction in GFR (an elevated serum creatinine)
- Active urine sediment (RBC’s, WBC’s, and RBC casts)
- Proteinuria (usually sub-nephrotic)
- Edema
- Hypertension
The presence of ______ correlates with RPGN and carries an ominous prognosis.
crescents
What is the tx for Post-infectious Glomerulonephritis?
none- it’s usually self limiting
Positive ANA and Anti-DS DNA indicates?
lupus
What are the path findings in IgA nephropathy?
- Light microscopy shows an increase in mesangial cell number and matrix
- IF shows IgA, IgG, and C3 in a mesangial pattern
- EM shows mesangial immune deposits.
This is IgA nephropathy with fever, rash, GI complaints, and renal disease.
Henoch-Schonlein purpura
What do the following findings indicate?
- IgG, IgM, C3 deposition on the GBM with subepithelial humps
- Infiltrates of PMNs and monocytes
Post-infectious Glomerulonephritis
What is another name or Bergers Syndrome?
IgA nephropathy
What is the tx for Alport Syndrome?
none
Patients with _____ have hematuria, dysmorphic red blood cells and/or red blood cell casts, and proteinuria.
nephritic syndrome
What do these findings indicate?
- Lumpy bumpy
- C3, IgG, IgM, IgA, and C1q
- mesangial, subendo, and subepi deposits
Lupus Nephritis
What is Henoch-Schonlein purpura?
IgA nephropathy with fever, rash, GI complaints, and renal disease
What are the pathologic findings of Post-infectious Glomerulonephritis?
- IgG, IgM, C3 deposition on the GBM with subepithelial humps
- Infiltrates of PMNs and monocytes
This is a form of mesangial proliferative glomerulonephritis in which there is a predominance of IgA immune deposits in the mesangium and rarely in subendothelial areas.
IgA nephropathy
What do the following pathological findings indicate?
- Light microscopy shows an increase in mesangial cell number and matrix
- IF shows IgA, IgG, and C3 in a mesangial pattern
- EM shows mesangial immune deposits
IgA nephropathy
Low C4 with + Rheumatoid factor is indicative of?
cryoglobinemia
What are the positive lab findings for cryoglobinemia?
- Low C4
- Rheumatoid factor
What nephritic syndrome occurs after a group A strep infection?
Post-infectious Glomerulonephritis
What are the pathology findings in Lupus Nephritis?
- Lumpy bumpy
- C3, IgG, IgM, IgA, and C1q mesangial, subendo, and subepi deposits
This is an X-linked disorder of type IV collagen.
Alport Syndrome
What are the pathologic findings of Pauci-Immune Renal Vasculitis?
- No immune complex deposition
- Fibroid necrosis and crescents
- p-ANCA to MPO and PR-3
What is the tx for cryoglobinemia?
- Antivirals
- rituximab
- plasmapheresis
What do these characteristics indicate?
- Reduction in GFR (an elevated serum creatinine)
- Active urine sediment (RBC’s, WBC’s, and RBC casts)
- Proteinuria (usually sub-nephrotic)
- Edema
- Hypertension
nephritic syndrome
Why is GFR reduced in nephritic syndrome?
the inflammatory process within the glomerulus results in glomerular vasoconstriction and/or occlusion or thrombosis
Lesions on light microscopy are termed _____ if they involve part of one glomerulus; _____ is the word used if only some glomeruli are involved.
segmental; focal
What lab findings indicate Post-infectious Glomerulonephritis?
- positive ASO
- decreased C3
In light microscopy, _____ are a special term when there is a proliferation of cells in Bowman’s capsule.
crescents
How does Post-infectious Glomerulonephritis usually present?
sudden onset edema and weight gain
Which nephritis presents concurrently with a viral infection?
Bergers/IgA nephropathy
______ is the most common type of acute glomerulonephritis now seen worldwide and usually presents in males 15 to 35 years old.
IgA nephropathy
What do these path findings indicate?
- No immune complex deposition
- Fibroid necrosis and crescents
- p-ANCA to MPO and PR-3
Pauci-Immune Renal Vasculitis
IgA nephropathy is the most common type of acute glomerulonephritis now seen worldwide and usually presents in _____.
males 15 to 35 years old
Nephritic syndrome is caused by _____.
glomerular inflammation
Positive ASO with decreased C3 indicates?
Post-infectious Glomerulonephritis
What is another name for IgA nephropathy?
Bergers Syndrome
Positive ASO indicates?
post-infectious/post-strep nephritis
What is the tx for Pauci-Immune Renal Vasculitis?
- Steroids + cyclophosphamide or rituximab
- plasma exchange
What 2 syndromes are associated with cryoglobinemia?
- HCV
- Sjögren’s syndrome
Post-infectious Glomerulonephritis occurs after ____ infection.
group A strep
What is IgA nephropathy?
a form of mesangial proliferative glomerulonephritis in which there is a predominance of IgA immune deposits in the mesangium and rarely in subendothelial areas
What is the tx for Bergers/IgA nephropathy?
- ACEI/ARBs
- Steroids +/- azathioprine
What are these path findings associated with?
Membranoproliferative pattern with subendo immune deposits of IgM Fingerprint pattern of appearance
cryoglobinema
Positive Anti-neutrophil cytoplasmic antibodies (ANCA) indicates?
Pauci-immune vasculitis
What are Sjögren’s syndrome and HCV associated with?
cryoglobinemia
What is the tx for Lupus Nephritis?
- High dose corticosteroids
- mycophenolate mofetil
- cyclophosphamide
Positive Anti-GBM antibodies indicates?
Anti-GBM disease, Goodpasture’s syndrome
What are the pathologic findings of cryoglobinemia?
Membranoproliferative pattern with subendo immune deposits of IgM Fingerprint pattern of appearance