Flashcards in Glomerular Disease Details Deck (65)
Alport Syndrome presentation?
Eye problems (retinopathy, lens dislocation) + glomerulonephritis + sensorineural deafness
+ Family hx
Alport Syndrome pathogenesis
Mutation in type IV collagen --> thinning and splitting (lamellated) of glomerular BM
Hereditary pattern of Alport Syndrome?
Alport Syndrome EM?
"Basket weave" appearance
Membranoproliferative glomerulonephritis presentation?
Nephritic syndrome that often copresents with nephrotic syndrome
Type I MPGN associations?
Hepatitis B or C
Type I MPGN Pathology
- SUBENDOTHELIAL IC deposits
- Granular IF
- "tram track" on PAS stain due to GBM splitting caused by mesangial ingrowth
Type II MPGN associations?
C3 nephritic factor --> stabilizes C3 convertase --> decreased serum C3 levels
What is Type II MPGN also called?
Dense deposit disease
Characteristics of nephrotic syndrome?
Massive proteinuria with hypoalbuminemia --> edema, hyperlipidemia (blood becomes thin so liver increases fat)
- Frothy urine with fatty casts
What is nephrotic syndrome caused by?
Podocyte damage --> disrupts glomerular filtration charge barrier
Why is nephrotic syndrome associated with hypercoagulable state?
Pee out ATIII in urine
What is nephrotic syndrome associated with infection?
Pee out Ig in urine
Presentation of minimal change disease (liphoid nephrosis)?
- Triggered by recent infection, immunization, immune stimulus
- May be secondary to lymphoma (CK-mediated damage)
Minimal change disease LM
Minimal change disease IF
Minimal change disease EM
Effacement of foot processes due to CKs
Describe the proteinuria of Minimal change disease?
Selective (loss of Alb but not Ig)
Treatment of minimal change disease?
Excellent response to steroids
Focal Segmental Glomerulosclerosis presentation?
AA and hispanics
Chronic kidney disease due to congenital malformations
Focal Segmental Glomerulosclerosis LM
Segmental sclerosis and hyalinosis
Focal Segmental Glomerulosclerosis IF
May be positive for nonspecific focal deposits of IgM, C3, C1
Focal Segmental Glomerulosclerosis EM
Effacement of foot processes
Focal Segmental Glomerulosclerosis treatment?
Inconsistent response to steroids, may progress to chronic renal disease
Membranous Nephropathy (Membranous GN) presentation?
Primary - Ab to phospholipase A2 R
Secondary - drugs (NSAIDs, penicillamine), infections (HBV, HCV), SLE, or solid tumors
Membranous Nephropathy LM
Diffuse capillary and GBM thickening
Membranous Nephropathy IF
Granular as a result of IC deposition (nephrotic presentation of SLE)
Membranous Nephropathy EM
"Spike and dome" appearance with subepithelial deposits
Membranous Nephropathy treatment?
Poor response to steroids, may progress to chronic renal disease