Nephritic Syndrome Flashcards
(24 cards)
What is nephritic syndrome?
Glomerular disease characterized by inflammation in the glomeruli and bleeding.
What are the common clinical findings in nephritic syndrome?
Azotemia and oliguria
RBC casts and dysmorphic RBCs in the urine
Hypercellular inflammed glomeruli on biopsy
What is the nephritic syndrome that arises after group A beta-hemolytic streptoccal infections?
Poststreptococcal Glomerulonephritis
What are the symptoms associated with PSGN?
- presents 2-3 weeks after infection.
- cola colored urine (hematuria).
- malaise, fever, nausea
- periorbital edema
What is the characteristic finding in PSGN on EM and IF?
EM-> Subepithelial humps
IM-> granular deposits of IgG and C3 in GBM and mesangium
What would IF show in PSGN?
Granular immune complex deposition.
What two diseases will show a granular immunofluorescence pattern?
1) PSGN
2) Diffuse proliferative Glomerulonephritis
What is the name of the nephritic syndrome in which progression to renal failure occurs in weeks to months?
Rapidly progressive Glomerulonephritis
What are the characteristic findings in rapidly progressive Glomerulonephritis?
Formation of cresents in the glomeruli.
What type of RPGN is characterized by linear deposits of IgG on immunofluorescence?
Goodpasture syndrome. Ab against collagen will be present in the glomeruli and alveolar basement membranes.
What types of RPGN are characterized by granular deposits on immunofluorescence?
PSGN and diffuse proliferative glomerulonephritis
What type of RPGN is characterized by negative findings on immunofluorescence?
Wegeners granulomatosis–> c-ANCA
Microscopic polyangiitis and Churg-Strauss–> p-ANCA
What are the contents of the crescents that are seen in RPGN?
Crescents: proliferation of parietal cells, macrophages, PMNs, and fibrin strands between cells.
- all contained within bowmans space.
What is the most common nephropathy worldwide?
IgA nephropathy
Where are IgA deposits found in IgA nephropathy?
IgA deposits are found in the mesangium and are detected by immunofluorescence
What is the common presentation seen in IgA nephropathy?
- Commonly presents during childhood as episodic or microscopic hematuria with RBC casts, usually following mucosal infections.
- infection causes increase in IgA production.
What is the name of the disease that is associated with an inherited defect in type IV collagen and what is its inheritance patten?
Alport syndrome.
X-Linked.
What is the result of defective type IV collagen in Alports syndrome?
-Thinning and splitting of the glomerular basement membrane resulting in a defective basement membrane.
What are the findings on EM in Alports syndrome?
Alternating thickening and thinning of the glomerular basement membrane.
What are the findings on LM, IF, and EM in IgA nephropathy?
LM-> focal mesangial proliferative glomerulonephritis; mesangial widening.
IF-> IgA and C3 in mesangium (can have IgM and IgG present).
EM-> mesangial and paramesangial dense deposits.
What is a frequent cause of recurrent gross or microscopic hematuria?
IgA nephropathy
What ar ether two eponymic diseases associated with IgA nephropathy?
1) Berger disease-> renal IgA nephropathy-no systemic diseasaae
2) Henoch-schonlein purpura (HSP)-> IgA nephropathy associated with systemic disease, often exhibiting skin (purpuric) manifestations.
What age group is primarily affected by IgA nephropathy?
Primarily a disease of older children and young adults ,most common in the 2-3 decades of life.
More common in white poeple and Asians
Men 2:1 women
What is a common antecedent infection that can cause a flare up of IgA nephropathy symptoms?
Commonly follows mucosal infections
