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11858920
Glomerulonephritis
Description
Causes of glomerulonephritis
Mind Map by
Louis Darby
, updated more than 1 year ago
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Created by
Louis Darby
over 6 years ago
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Resource summary
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)
Tx: If normal renal function / BP - no tx. If yes - corticosteroids +/- IS
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
Sx: Nephritic syndrome / Generalised symptoms
Dx: Identify cause - serology / immunostaining / biopsy
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
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
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
Membranous GN
Ax: Immune complexes 1ry - idiopathic / 2ry to Drugs / infections / SLE / CANCER
Tx: Treat cause / steroids +/- IS
Dx: Tissue biopsy - immune complexes
Secondary causes
Diabetes / amyloidosis / Haematological malignancies / infections / preeclampsia
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
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)
Dx: Bloods - low complement. Look for 2ry causes - infection / SLE. Renal biopsy
Tx: Steroids
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