Nephrotic / Nephritic syndromes
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| Poststreptococcal glomerulonephritis | NEPHRITIC- most common type of postinfections GN; usually follows group A strep infection of the skin and pharynx LM: glomeruli enlarged and hypercellurlar, neutrophils, "lumpy bumpy"; EM subepithelial humps; IF granular pattern; ICs activate complement p
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| Rapid Progressive (crescentric) glomerulonephritis | NEPHRITIC - rapid loss of renal function progresses to acute renal failure; LM and IF; may or may not be associated with crescent formation (# of crescents is what determines prognosis) Associated with goodpastures, microscopic polyarteritis (p-anca) and
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| Membranoproliferative glomerulonephritis [diffuse proliferative GN] | NEPHRITIC -subendothelial IC deposits with granular IF; EM subendothelial humps "tram tracks"; DNA-anti DNA ICs activate classical complement pathway; common cause of death is SLE, "wire looping"
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| IgA glomerulonephropathy (Bergers disease) | Most common GN almost equal incident of nephritic or neprhotic presentation; Affects children and adults, often post infectious; increased mucosal synthesis and decreased clearance of IgA; increased serum IgA; Mesangial IgA IC deposits within granular. Pr
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| Alport syndrom | split basement membrane; collagen IV mutation; nerve deafness and ocular disorders
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| Nephritic syndrome | hypertension [due to salt retention]
periorbital puffiness due to salt retention
oliguria (<400 ml urine/day) due to decrease in GFR from inflamed glomeruli
hematuria-dysmorphic RBC with irregular membranes,
neutrophils in sediment
RBC casts are KEY
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| Nephrotic syndromes | Key finding is proteinuria greater than 3.5 g/24hrs
generalized pitting edema and acites due to hypoalbuminemia, and spontanteous peritonitis (strep pnemo); hypertension in some types; hypercoaguable states due to loss of antithrombin III, hypercholester
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| Membranous glomerulonephritis | NEPHROTIC:MCC of nephritic syndrome in adults; Drugs captopril; infx with HBV, plasmodium malaria, syphillis; Malignancy: carcinomas non-hodkins lymphoma;
Autoimmune disease; SLE
LM: diffues thickening of memebranes
EM: silver stain show spike and dome
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| Minimal change disease | NEPHROTIC:negative IF, EM shows fusion of podocytes and no deposits; T cell cytokines cause the GBM to lose its negative charge; selective proteinuria (albumin and globins), often preceeded by respiratory infxn or routine immunization; structurally normal
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| Focal segmental glomerular sclerosis | NEPHROTIC:Primary of secondary causes disease
secondary cause is HIV and IV heroin use
negative IF;
EM focal damage of visceral epithelial cells
LM: segmental sclerosis and hyalinosis
seen in african americans
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| Diabetic nephropathy | LM : kimmelston wilson "wire loop" lesions, basememnt memebrane thickening;nodular glomerular changes
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| Amyloidosis | IF congo red stain apple green bifringence; Associated with Multiple myeloma, chronic conditions, TB rheumatic arthritis
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Created by:
Roshani
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