Quick Summary of Nephritic Syndromes - USMLE Forums
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Old 04-21-2012
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Kidney Quick Summary of Nephritic Syndromes

NephrItic Syndromes:

Common Symptoms of Nephritic Syndrome include - Hematuria, Oliguria, HTN, Azotemia, Periorbital Edema

1) Post-Streptococcal Glomerulo-Nephritis (PSGN)
  • Occurs 2 - 3 weeks after infection with Group A Beta Hemolytic Infection (Strep. Pyogenes)
  • Virulence factor: M Protein
  • Common in Children (self limited, good prognosis)
  • In adults, it often progresses to RPGN
  • EM: SubePIthelial 'Humps' (deposits of IC)
  • H&E: Hypercellular & Inflammed Glomeruli
  • IF: Granular IC deposition

2) Good Pasture Syndrome
  • Antibodies against Type IV Collagen which is seen in Glomerulus & Alveolar Basement Membranes (Mnemonic: Type FOUR, On the FLOOR)
  • IF: Linear
  • Common symptoms of Nephritic Syndrome

3) Diffuse Proliferative Glomerulo-Nephritis (DPGN)
  • SubENDOthelial Antigen-Antibody complex deposition
  • Most common renal complication of SLE !!!
  • IF: Granular

4) Rapidly Progressive Glomerulo-Nephritis (RPGN)
  • H&E: Crescents in Bowman Space which are composed of Fibrin & Macrophages.
  • Do ImmunoFluorescence to find out the cause of RPGN
  • Granular IF: PSGN or DPGN
  • Linear IF: Good Pasture Syndrome
  • Negative IF: Pauci-Immune, then test for ANCA's
  • C-ANCA: Wegner's Granulomatosis
  • P-ANCA: Microscopic Polyangitis or Churg Strauss Syndrome
  • Churg Strauss differs from Polyangitis in 3 ways
    - 1) Granulomatous inflammation
    - 2) Eosinophilia
    - 3) Asthma

5) IgA Nephropathy
  • IgA deposition in Mesangium
  • IF: Granular
  • Has episodic presentation as it follows mucosal infections
  • Good prognosis

6) Alport Syndrome
  • X-Linked
  • Defect in Type IV Collagen
  • Triad: Hematuria, Sensory hearing loss & Occular disturbances
  • EM: Thinning & Splitting of GBM

Feel free to add to the list in case I missed something!

*** Good for practice: Go through these and try to write them down again. Use a simple format like the one I used. EM, IF, H&E, Associations if any, Commonly seen in, Tx if any, etc etc. I was able to write all of this down from memory and it was really good practice! ***
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