- A group of disorders
- With immunologically mediated injury to glomerulus
- Involving both kidneys
- With secondary injury after initial immune insult
- May be part of generalised disease
- Classified by histology
Pathogenesis
- Deposition of immune complexes
- Deposition of anti-glomerular basement membrane (anti-GBM) antibody
Aetiology
- Immune complex nephritis
- Unknown antigen
- Viruses
- Mumps
- Measles
- Hepatitis B and C
- Epstein-Barr virus (EBV)
- Coxsackie
- Varicella
- HIV
- Bacteria
- Group A Beta-haemolytic streptococci
- Streptococcus viridans
- Staphylococci
- Treponema pallidum
- Gonococci
- Salmonellae
- Parasites
- Plasmodium malariae
- Schistosoma
- Filiariasis
- Host antigens
- DNA (systemic lupus erythematosus - SLE)
- Cryoglobulins
- Malignant tumours
- Drugs
- Penicillamine
- Anti-GBM antibody
- Antibodies to type IV collagen
- Secondary mechanisms
- Complement activation
- Fibrin deposition
- Platelet aggregation
- Neutrophil-driven inflammation
- Kinin activation
- Clinical features
- GN presents in one of four ways
- Asymptomatic proteinuria +/- microscopic haematuria
- Acute nephritic syndrome
- Nephrotic syndrome
- Chronic renal failure
Investigations
- 24 hour urinary protein (measure twice)
- Urine microscopy
- Renal function
- Auto antibodies
- Renal biopsy
No comments:
Post a Comment