11858920
Beschreibung
Mindmap von Louis Darby, aktualisiert more than 1 year ago
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Erstellt von Louis Darby
vor etwa 8 Jahre
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Glomerulonephritis
- Nephritic Syndrome
- Haematuria /
Proteiurina
<3g/24hrs /
HTN / Oliguria
- IgA nephropathy
- IgA immune complex in
glomeruli / Occurs 1-2 days after
febrile illness
- Dx: Urine: RBC casts /Tissue
biopsy: IgA and complement
deposits
- Biopsy looks like HSP
(also IgA mediated)
- Biopsy looks like HSP
(also IgA mediated)
- Tx: If normal renal
function / BP - no tx. If yes
- corticosteroids +/- IS
- IgA immune complex in
glomeruli / Occurs 1-2 days after
febrile illness
- Rapidly
Progressive GN
- Can cause renal
failure in weeks to
months
- Tx: Corticosteroids +/-
immunosuppression.
Anti-GBM - plasmapheresis
- Categories
- Anti-GBM (Goodpasture's) -
can cause renal-pulmonary
syndrome
- Immune complex e.g.
Infectious - post-strep / bac
endocaridits / Hep B. SLE /
IgA
- Pauci-immune -
ANCA +ve
vasculitis
- Anti-GBM (Goodpasture's) -
can cause renal-pulmonary
syndrome
- Sx: Nephritic syndrome /
Generalised symptoms
- Dx: Identify cause -
serology /
immunostaining /
biopsy
- Can cause renal
failure in weeks to
months
- Tx: HTN - ACEI /
oedema - fluid
restrict /
Steroids +/- IS
- Post-infectious GN
- 1-2 weeks post
streptococcal infection
(pharyngitis / impetigo)
- Bacterial antigens
bind to glomerulus
and attract immune
response
- Dx: Urinalysis - RBC casts/ ASO
titre +ve/ Bloods: Low
complement levels/ Biopsy - WC
infiltration
- Tx: Supportive / dialysis if serious
- 1-2 weeks post
streptococcal infection
(pharyngitis / impetigo)
- Haematuria /
Proteiurina
<3g/24hrs /
HTN / Oliguria
- Nephrotic syndrome
- Proteinuria >3g/24hrs
/ Hypoalbuminaemia
/ Oedema
- Tx: Proteinuria - ACEI /
Oedema -Na+
restriction / diuretics
- Primary Causes
- Minimal change nephropathy
- Seen in Children.
Responds very
well to steroids
- Clinical Dx, normal
renal function and
biopsy
- Seen in Children.
Responds very
well to steroids
- Focal Segmental GN
- Ax: Idiopathic /
2ry to HIV / drugs
/ SLE / SCD
- Dx: Tissue biopsy /
Immuno: IgM
complexes and
complement
- Young black males
- Tx: underlying cause /
ACEI / steroids
- Ax: Idiopathic /
2ry to HIV / drugs
/ SLE / SCD
- Membranous GN
- Ax: Immune complexes 1ry
- idiopathic / 2ry to Drugs /
infections / SLE / CANCER
- Tx: Treat cause /
steroids +/- IS
- Dx: Tissue biopsy -
immune complexes
- Ax: Immune complexes 1ry
- idiopathic / 2ry to Drugs /
infections / SLE / CANCER
- Minimal change nephropathy
- Secondary causes
- Diabetes / amyloidosis /
Haematological malignancies /
infections / preeclampsia
- Diabetes / amyloidosis /
Haematological malignancies /
infections / preeclampsia
- Proteinuria >3g/24hrs
/ Hypoalbuminaemia
/ Oedema
- Mixed Nephritic - Nephrotic
- Haematuria /
Proteinuria
>3g/day
- Lupus Nephritis
- Immune complex
mediated - nuclear
antigens and anti-dsDNA
abx
- Dx: SLE diagnosis -
antidsDNA +ve. Biopsy
- Can lead to RPGN
- Tx: Cortiocsteroids +/- IS
(treat SLE). Treat HTN with ACEI
- Immune complex
mediated - nuclear
antigens and anti-dsDNA
abx
- Membranoproliferative
GN
- Type I - proliferation + immune
deposits - 2ry to SLE / chronic
infection - bacterial endocarditis
/ HIV / Hep B&C / Cancer
- Type II - Complement
mediated - C3 nephritic
factor (anti C3 convertase)
- Type II - Complement
mediated - C3 nephritic
factor (anti C3 convertase)
- Dx: Bloods - low
complement. Look for 2ry
causes - infection / SLE.
Renal biopsy
- Tx: Steroids
- Type I - proliferation + immune
deposits - 2ry to SLE / chronic
infection - bacterial endocarditis
/ HIV / Hep B&C / Cancer
- Haematuria /
Proteinuria
>3g/day
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