Causes of Rapidly Progressive Glomerulonephritis
Hi there - I thought I'd share this in case this helps someone - Rapidly progressing glomerulonephritis comes in 3 types:
Type 1 involves anti glomerulo basement membrane antibodies and includes Goodpastures
Type 2 involves immune complex deposition and so a lumpy bumpy pattern and can be sequelae for Post strep glomerulonephritis / SLE / IgA nephropathy and Henoch Schloein Purpura
Type 3 is Pauci Immune and involves a lack of immune complexes (Ig) or C3 in the renal biopsy and can be accompanied by URI symptoms.
My question is if you have renal symptoms and hematuria how are you supposed to distinguish between Pauci immune and Goodpastures if they don't give you a biopsy? Do we need to know the treatment or labs that distinguish between these types?
They won't ever ask you to differentiate between the two without giving you the biopsy, because this is the situation in real life practice.
Although you may need the biopsy for a definite diagnosis, I think you should still know a bit about their presentations. Goodpasture's present with hematuria and hemoptosis ( because the antibodies that attack the glomerular basement membrane in the kidney's also attck basement membranes in the lung). The Pauci-immune RPGN's are mostly necrotizing vasculitis such as Wegener's, Churg- Strauss and microscopic polyangiitis, and they also have hematuria and hemoptosis, but they also have pupura and ANCA. Also, it seems that the pauci- immune diseases have more widespread systemic involvement than Goodpasture's. Hope that helps!
Ohhh - Pauci Immune is a group of diseases? Not a separate disease... Thanks for clarifying that - phew - one less thing to memorize..
So Churg strauss / Wegeners / Microscopic polyangitis are all ANCA positive vasculitis
Thanks for your help guys!
|All times are GMT -8. The time now is 01:41 PM.|
Powered by vBulletin® Version 3.8.8
Copyright ©2000 - 2020, vBulletin Solutions, Inc.
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2020 DragonByte Technologies Ltd.
USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2019)