Rapdily Progressive Glomerulonephritis Flashcards
(25 cards)
What is rapidly progressive glomerulonephritis?
Rapidly Progressive Glomerulonephritis (RPGN) refers to a rapid deterioration in renal function accompanied by the nephritic syndrome
What is the pathological finding for RPGN?
Crescents in half of the glomeruli due to proliferation of epithelial cells in Bowman’s space due to severe glomerular capillary injury
What is the presentation of RPGN?
Presenting features include
Oliguria, anorexia, nausea and vomiting.
nephritic syndrome features like hypertension, proteinuria, haematuria and oliguria
Extrarenal symptoms
What are the investiga
Which extrarenal symptoms incidcate lupus?
Mucosal ulceration
Which extrarenal symptoms incidcate anti-GM disease?
Shortness of breath and haemoptysis
Which extrarenal symptoms incidcate IgA issues?
Abdominal pain
What is RPGN caused by?
Anti-GBM disease/Goodpasture’s
ANCA associated with granulomatous is with polyangitis or microscopic polyangitis
Lupus nephritis
What investigations should be done for RPGN?
ANCA to rule out IgA vasculitis
Anti-nuclear antibodies, anti-dsDNA and anti-smith antiboides for SLE
Serology for post-infectious glomerulonephritis like anti-streptolysin titre
Urine dip urine protein: creatinine ratio
Which imaging can be performed?
Renal ultrasound
CXR or CT scan
What is the definitive diagnostic test for RPGN?
RENAL BIOPSY
WHAT IS THE initial management of lupus causing RPGN?
CYLOphopshamide (anti neoplastic drug that causes DNA cross links)
High dose steroids
What is the maintenance for lupus?
Azathriopine (inhibits purine synthesis) and steroids
What is membranoproliferative glomerulonephritis?
Arises from chronic hepatitis C, casing A rapid decrease in glomerular filtration rate, as evidenced by increased serum creatinine over a short period of time, red blood cell casts on urinalysis, and crescent formation on a renal biopsy
What is an indicatior of rapidly progressive glomerulonephritis?
Both pulmonary and renal involvement
What causes eye involvement?
Granulomatous is with polyangitis which causes proposes and cranial nerve lesions
What type of vasculitis is microscopic polyangiitis?
Small-vessel ANCA vasculitis
What are common renal impairments associated with microscopic polyangiitis?
- Raised creatinine
- Haematuria
- Proteinuria
What systemic symptoms can be seen in microscopic polyangiitis?
- Fever
- Lethargy
- Myalgia
- Weight loss
What type of rash is associated with microscopic polyangiitis?
Palpable purpura
What respiratory symptoms might occur in microscopic polyangiitis?
- Cough
- Dyspnoea
- Haemoptysis
What is mononeuritis multiplex?
Asymmetric damage to peripheral nerves causing pain and redness
What is the percentage range for positive pANCA in microscopic polyangiitis?
50-75%
What is the percentage range for positive cANCA in microscopic polyangiitis?
40%
