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Lecture 4 (1of3) - Nephritic Syndrome
Lecture 4 (1of3) - Nephritic Syndrome
•IgA nephropathy
Epidemiology:
PSGN is the most common cause of acute nephritis in children,
it primarily occurs in developing countries.
Light microscope:
Immunofluorescence microscopy
Immunofluorescence (IF) microscopy reveals :
A characteristic pattern of deposits of immunoglobulin G (IgG) and C3
distributed in a diffuse granular pattern within the mesangium and
glomerular capillary walls;
Morphology of postinfective glomerulonephritis:
Electron microscopy :
The most characteristic feature detected by
electron microscopy (EM) are the dome-shaped subepithelial
electron-dense deposits that are known as humps.
CLINICAL MANIFESTATIONS:
Serology:
•Anti-streptolysin (ASlO)
•Anti-hyaluronidase (AHase)
•Anti-streptokinase (ASKase)
•Anti-DNase B antibodies.
Indications for renal biopsy
Supportive care :
•Patients with PSGN have variable reductions in renal function and some
patients require dialysis during the acute episode.
Dialysis indications:
This patients who present with acute renal failure and may have
crescents on the initial renal biopsy their kidney function recovers
totally.
anti-GBM antibody (Goodpasture's) disease
•Hematuria
•Nephritic sediment - dysmorphic red blood cells, red blood cell casts.
•cough,
Renal and patient survival correlates closely with the degree of renal
impairment at presentation.
hemolytic anemia,
thrombocytopenia,
Plasma exchange
Steroids