| ID | 132 |
|---|---|
| Name | A. NEPHRITIC SYNDROME |
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| Introduction | Glomerular diseases presenting as nephritic syndromes are associated with a clinical presentation, characterised with- 1. Haematuria (red or brown urine) 2. Oedema and generalised fluid retention 3. Hypertension 4. Moderate degree of proteinuria 5. Red blood cell casts & 6. Oliguria |
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| Classification | Classification of nephritic syndromes: 1. Acute (poststreptococcal) glomerulonephritis: This occurs as a result of infection with a nephritogenic strain of group A (haemolytic) streptococci, specially type-12. In this circulating IgG immune complexes are trapped and deposited under the epithelium. Histopathologically presents diffuse proliferative glomerulonephritis. (For detail see below). 2. IgA Nephropathy: i. Berger’s diseases: It is a primary renal disease & is more common form of acute glomerulonephritis. In this IgA is deposited in the glomerular. The exact cause is unknown. In this gross haematuria is the commonest presenting complaint with other nephritic manifestations. ii. Henoch-schonlein purpura (Anaphylactoid purpura): This is also a nephritic disorder, in which renal lesion is identical to IgA nephropathy with mesangial deposition of IgA, but clinical presentation of this disorder is clearly different. There are palpable purpura caused by leukocytoclastic vasculitis, arthralgias & abdominal symptoms. Purpuric skin lesions are often located on the lower extremities. Male children are commonly affected. In this renal insufficiency is common with nephritic prsentation. 3. Rapidly progressive (crescentic) glomerulonephritis: This can be defined as any glomerular disease associated with rapid progressive loss of renal function over days or weeks, but nephritic manifestations are similar irrespective of the cause. The following may be considered in this group: i. Pauci-immune glomerulonephritis (ANCA-associated). ii. Anti-GBM glomerulonephritis (Goodpasture’s syndrome), iii. Cryoglobulin-associated glomerulonephritis. iv. Lupus erythematosus. |
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