Pathology of Nephrotic Syndrome Flashcards
What is the most common nephrotic disorder in adults?
Focal segmental glomerulosclerosis
Segmental sclerosis and hyaline deposition are characteristic of what nephrotic syndrome?
Focal segmental glomerulosclerosis
What is the most common nephrotic disorder in children?
Minimal change disease
True/False. Membranoproliferative glomerulonephritis can present as either nephritic or nephrotic disorders?
True - it can also present as both
What complement protein is excessively activated in Type II MPGN?
C3 (alternative pathway)
Some cases of membranous nephropathy is caused by autoantibodies against what antigen?
M-type Phospholipase A2 Receptor (PLA2R)
Hyperlipidemia is associated with nephrotic disorders. Why is this?
Protein is being lost in the urine. The body increases synthesis of lipoproteins, which includes LDL, leading to hyperlipidemia
Describe the pathogenesis of focal segmental glomerulosclerosis.
Degeneration and disruption of epithelial cells with effacement of foot processes. Eventually leads to detachment of foot processes (similar process to minimal change disease)
Diffuse thickening of the glomerular capillary wall due to immune deposits is characteristic of this nephrotic disorder.
Membranous nephropathy
Mesangial sclerosis in diabetic neuropathy is positive for what stain?
PAS+
What are Kimmelstiel-Wilson lesions?
Nodules of mesangial sclerosis found in diabetic nephropathy
What risks are most associated with Type I MPGN?
SLE, CLL, hepatitis B, hepatitis C
What stain is utilized to identify renal amyloidosis?
Congo Red Stain
There are two types of membranoproliferative glomerulonephritis. How do they differ?
Type I - Deposition of IgG and complement immune complexes
Type II - Activation of complement
True/False. Minimal change disease responds well to treatment with corticosteroids.
True
What is the leading cause of end-stage renal disease in the US?
Diabetic nephropathy
This nephrotic disorder has a “pin and dome” appearance on EM.
Membranous nephropathy
Both types of membranoproliferative glomerulonephritis present with a “tram track” appearance of the basement membrane on light microscopy. How do they differ on EM?
Type I - subendothelial deposits
Type II - intramembranous deposits
What histologic findings are present on analysis of a nephron in a patient with minimal change disease?
Diffuse effacement of epithelial foot processes, no deposits, no immune complexes
True/False. Focal segmental glomerulosclerosis responds well to corticosteroid treatment.
False - this is one of the distinguishing factors between FSGS and minimal change disease
Diabetic neprhopathy begins with thickening of the basement membrane. What pathologic changes occur as the disease progresses?
Expansion of the mesangial matrix forming nodular sclerosis and hyaline arteriolosclerosis
What symptoms are most associated with nephrotic disorders?
Proteinuria, hypoalbuminemia, hyperlipidemia, edema
This variant of focal segmental glomerulosclerosis is due to podocyte expression of HIV genes.
Collapsing variant of FSGS
