Nephrotic Syndromes Flashcards
(28 cards)
What are the characteristics of nephrotic syndrome?
- Oedema
- Proteinuria (>3.5g/day)
- Hypoalbuminemia
- Hypogammaglobulinemia
- Hypercoagulable state
- Hyperlipidemia and hypercholsterolemia
What will the urine look like on nephrotic syndrome?
Frothy
- Will have fatty casts
Why is nephrotic syndrome associated with a hypercoagulable state?
Antithrombin III is lost in the urine
What coagulation factors does ATIII affect?
2, 9, 10, 11
Why is nephrotic syndrome associated with an increased risk of infection?
Loss of IgGs in urine (hypogammaglobinemia)
What is the most common nephrotic syndrome in children?
Minimal change disease
What can primary minimal change disease be caused by?
- Idiopathic
- Immunisation
- Immune stimulus
- Infection
4 i s
What can secondary minimal change disease be due to?
Lymphoma (cytokine-mediated change)
What is minimal change disease treated with?
Corticosteroids
- Primary disease has excellent response
What is minimal change disease also known as?
Lipoid nephrosis
What histology show in minimal change disease?
Light Microscopy - Normal glomeruli (lipid may be seen in PCT cells)
Negative immunoflouresence
Electron Microscopy - Effacement of podocyte foot processes
What groups of people have a higher risk of Focal Segmental Glomerulosclerosis?
Black people
Secondary disease may be due to:
- HIV
- Sickle cell
- Heroin
- Obesity
- Interferon treatment
- Congenital malformations
What can FSGS be treated with?
Steroids - inconistent response
What will light microscopy show in FSGS?
Segmental sclerosis and hyalinosis
What will Immunoflouresence show in FSGS?
- Often negative
- May be positive for nonspecific focal deposits of IgM, C3, C1
What will electron microscopy show in FSGS?
Effacement of foot processes similar to minimal change disease
What is membarnous nephropathy also known as?
Membranous glomerulonephritis
What is membranous nephropathy’s response to corticosteroids like?
Poor response
What is primary membranous nephropathy due to?
Antibodies to phospholipase A2 receptor (anti-PLA2R)
What is secondary membranous nephropathy due to?
- Infection: HCV, HBV
- Autoimmune: SLE
- Medications (NSAIDs, Penicillamine, Gold)
IMA Proud member of the spike and dome club
What will light microscopy show in membranous nephropathy?
Diffuse capillary and GBM thickening
What will immunoflouresence show in membranous nephropathy?
Granular due to immune complex (IC) deposition
What will electron microscopy show in membranous nephropathy?
“Spike and Dome” appearence of epithelial deposits
What chronic conditions can predispose to amyolid deposition?
- AL amyloid
- AA amyloid
- Prolonged dialysis
