Nephritic Syndromes

  • Hematuria
  • Hypertension
  • Oliguria
  • Azotemia

Acute Post Streptococcal GN

  • LM-Glomeruli enlarged and hypercellular with neutrophils.
  • Lumpy bumpy
  • IF-Granular starry sky pattern
  • EM-subepithelial deposits of Ig G and C3
  • Occurs 2 weeks after streptococcal pharyngitis/Pyoderma.
  • Low C3,normal C4
  • High ASO titer
  • Self limited,excellent prognosis in children.
  • Mortality 25% if CHF develolps.

Rapidly Progressive GN/Cresentic GN

  • Positive ANCA.
  • Inflammatory cell deposits in Bowmans capsule and crescent formation.
  • A/w PAN,wegners.
  • Rapid course of renal failure
  • Corticosteroids,plasmapheresis,Immunosuppressive agents may slow progression.
  • Renal transplant frequently required.
  • Number of crescents indicates prognosis.

Membranoproliferative/Mesangioproliferatve GN

  • EM-Type 1 has subepithelial humps basement membrane thickening with double layer-Tram track.
  • A/w HCV,infections,Autoimmune,idiopathic.
  • All types have low C3.
  • Type II involves C3 nephritic factor.
  • 50%present as nephrotic syndrome.
  • Slowly progress to renal failure>10 yrs.

Good pasture’s Syndrome

  • IF-Linear pattern of anti GBM antibodies
  • Hemoptysis,chestpain,dyspnoea,hematuria.
  • Type II hypersensitivity.
  • Treat with plasmapheresis.

IgA nephropathy

  • Berger’s disease
  • Mesangial IgA deposits
  • Paainless recurrent hematuria in young men.
  • 24-48 hours after pharyngeal/GI infection
  • Similar picture seen in HSP
  • Good prognosis in children.
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