Glomerulonephritis

Glomerulonephritis

100

What do you expect to see on IgG immunofluorescence of pauci-immune glomerulonephritis?

NOTHING!!!!

200

What does anti-GBM autoantibody bind to?

alpha3 chain on type IV collagen

300

What autoantibody contributes to the pathogenesis of Dense Deposit Disease (membranoproliferative glomerulonephritis Type II)?

C3 nephritic factor (C3NeF)

400

Name 3 infections that are associated with post-infectious glomerulonephritis that are NOT streptococcal or GAS infections.

Staphylococcal, Pneumococcal, HIV, HepB, HepC, Bacterial endocarditis

500

Which antibodie(s) are used for the immunofluorescent detection of granular deposits in lupus nephritis?

Full House! IgG, IgA, IgM, C3, C4

Renal Biopsy

100

Name the nephritic syndrome.

Goodpasture Syndrome

linear pattern on IgG IF

200

What is wrong with this glomerulus? 

Crescent (rapidly progressive glomerulonephritis)

300

Name the nephritic syndrome. 

Post-streptococcal glomerulonephritis (PSGN) 

Large electron-dense subepithelial "humps" deposits

400

What is wrong with this glomerulus?

Expanded mesangium (IgA nephropathy)

500

Name the nephritic syndrome.

Membranoproliferatuve glomerulonephritis Type I

mesangial cell invading and splitting BM

Definitions

100

What is the clinical manifestation of glomerulonephritis?

Nephritic Syndrome

200

What type of glomerular disease is defined by reversible kidney injury with proteinuria, hematuria, HTN, and edema?

Acute glomerulonephritis

300

What type of glomerular disease has a characteristic crescent on renal bx?

Rapidly Progressive Glomerulonephritis

400

What pattern of disease is characterized by thickened capillary walls and a "tram track" BM splitting?

Memranoproliferative

500

What does ANCA stand for?

Antineutrophil cytoplasmic antibody

Cases

100

24 y/o male c/o hemoptysis for 2 days. His CXR shows pulmonary infiltrates. His labs showed azotemia, proteinuria, and hematuria. What serum titers would be elevated on further evaluation?

Anti-GBM antibody (Goodpasture syndrome)

200

18 y/o female c/o cough and a fever for 4 days. She mentions she has had dark urine and decrease urine output since yesterday. UA showed proteinuria and hematuria. What do you expect to see on EM of her renal bx?

Mesangial deposits (IgA nephropathy)

300

16 y/o female has sudden onset fever with a rash and joint pain. Her kidney function tests are abnormal. What pattern of glomerular disease would you see on her renal bx?

diffuse proliferative glomerulonephritis (lupus nephritis- "wire looping" around capillaries, hypercellularity, granular IF)

400

30 y/o male with h/o IV drug use comes in with "cola" urine and decreased urine output. His BP is 170/90 and he has slight periorbital edema. His labs show hematuria, proteinuria, and hypocomplementemia. His renal bx shows tram track BM splitting. What is the most likely cause of his kidney problems?

Dense Deposit Disease (Membranoproliferative Glomerulonephritis Type II)

500

24 y/o male presents with dyspnea and hemoptysis x 1 wk. He has crackles and 2+ protein and blood on UA. He has a h/o chronic sinus infections. PE revealed purple-red lesions on his feet. What serum titer would you expect to be elevated?

c-ANCA/PR3-ANCA (Granulomatosis with polyangiitis)