Renal pathology Flashcards
Primary causes of nephrotic syndrome
Minimal change disease
Membranous glomerular disease
Focal segmental glomerulosclerosis
Minimal change disease
Most common in kids
Loss of podocyte foot processes on EM
No immune deposits
90% respond to steroids
Membranous glomerular disease
Adults
Diffuse glomerular BM thickening
Cancer, silver stain
Loss of podocyte foot processes. Subepithelial deposits = spikes
iG and complement in granular deposits along entire GMB
Poor response to steroids
Focal segmental glomerulosclerosis
Afrocarribean
Loss of podocyte foot processes
50% respond to steroids
Causes of nephritic syndrome
Acute post-infectious GN IgA nephropathy (Berger disease) Rapidly progressive (crescentic) GN Hereditary nephritis (Alport's) Thin basement membrane disease
Acute post infectious (post-strep) GN
1-3w after strep throat infection or impetigo (GAS)
Immune complex deposition
Increased ASOT titre
IgA nephropathy (Berger)
Commonest GN worldwide
Deposition of IgA immune complexes
1-2d after URTI with frank haematuria
Rapidly progressive GN
Most aggressive GN
Oliguria and renal failure more pronounced
Type 1: Anti GMB antibody against collagen T4 (Goodpasture’s). HLA DRB1
Type 2: Immune complex mediated
Type 3: pauci-immune/ANCA associated. cANCA (Wegener’s) or pANCA (microscopic polyangitis)
Hereditary nephritis (Alport’s)
Mutation in type4 collagen alpha 5 chain
x linked
Nephritic syndrome + sensorineural deafness + eye disorders
Thin basement membrane disease (benign familial haematuria)
V rare
Mutation in type 4 collagen alpha 4 chain
Usually asymptomatic
Asymtpomatic haematuria
Thin basement membrane disease (benign familial haematuria)
IgA nephropathy (Berger)
Alport syndrome
Tubulointerstitial nephritis
Acute pyelonephritis
Chronic pyelonephritis and reflux nephropathy
Acute interstitial nephritis: hypersensitivity reaction, usually to drugs
