Nephrotic Syndromes Flashcards
What is the kidney syndrome that can be classified as either nephrotic or nephritic?
membranoproliferative glomerulonephritis
Type I membranoproliferative glomerulonephritis looks like what?
subendothelial immune complexes.
tram-track appearance on PAS stain
What are the features of Type II membranoproliferative glomerulonephritis?
intramembranous dense deposits
What causes Type 1 membranoproliferative glomerulonephritis?
Hep B or Hep C
Lupus
Subacute bacterial endocarditis
What causes Type 2 membranoproliferative glomerulonephritis?
decreased C3 levels b/c of lack of C3 nephritic factor, which is stabilizing
What are the main features of nephrotic syndrome?
protein>3.5 g/day
hypoalbuminemia
edema
**may also show increased susceptibility to infections b/c of loss of immunoglobulins and increased risk of thrombosis b/c of loss of antithrombin
Hyperlipidemia, frothy urine w/ fatty casts
What does focal segmental glomerulosclerosis look like on light microscopy? IF? EM?
LM: segmental sclerosis, hyalinosis
IF: focal deposits of IgM, C3, C1
EM: effacement of foot processes
What is the #1 cause of glomerular problems in African Americans, Latinos, and those w/ HIV infection?
Focal Segmental Glomerulosclerosis
What does minimal change disease look like on LM, EM? Population it targets?
Children!!
LM: normal glomeruli
EM: effacement of foot processes
What triggers minimal change dx? Treatment?
recent infection or immunization, sometimes lymphoma
treated w/ corticosteroids
What is the #1 cause of nephropathy in caucasian adults?
membranous nephropathy
What are the features of membranous nephropathy? LM, IF, EM?
LM: GBM thickening
IF: granular, IC deposition
EM: spike and dome w/ subepithelial deposits
What are nephropathies that can cause sub epithelial deposits? Subendothelial?
Subepithelial: Membranous Nephropathy, Post-strep glomerulonephritis
Subendothelial: membranoproliferative glomerulonephritis
Which conditions is amyloidosis related to? What does it look like on LM?
multiple myeloma, TB, rheumatoid arthritis
**congo red stain shows apple green birefringence under polarized light
What does diabetic glomerulonephropathy look like?
mesangial expansion
GBM thickening
Kimmelstiel Wilson nodules that are pink.
caused by non enzymatic glycosylation of the GBM
