Difference between revisions of "Medical kidney diseases"

Jump to navigation Jump to search

Medical kidney diseases (view source)

Revision as of 19:50, 29 October 2011

3,189 bytes removed ,  19:50, 29 October 2011
→‎Nephrotic syndrome: mv to separate article
(→‎Nephrotic syndrome: mv to separate article)
Line 403: Line 403:


=Nephrotic syndrome=
=Nephrotic syndrome=
In children nephrotic syndrome is assumed to be ''minimal change disease''.  Biopsies are done only there is no response to steriods.


==Minimal change disease==
This includes the following:
===General===
*[[Minimal change disease]].
*Responds to steroids.
*[[Focal segmental glomerulosclerosis]].
 
*[[Membranous nephropathy]].
===Microscopic===
Features:
*No changes on light microscopy.
 
===EM===
Features:
Diffuse loss of foot processes.
 
Image:
*[http://commons.wikimedia.org/wiki/File:Minimal_Change_Disease_Pathology_Diagram.svg MCD - schematic (WC)].
 
==Focal segmental glomerulosclerosis==
===General===
*Abbreviated ''FSGS''.
*Presents as nephrotic syndrome.
*Does not respond to steroids (unlike MCD).
 
====Etiology====
*Primary.
**May be familial.<ref name=pmid12778884>{{cite journal |author=Sánchez de la Nieta MD, Arias LF, Alcázar R, ''et al.'' |title=[Familial focal and segmentary hyalinosis] |language=Spanish; Castilian |journal=Nefrologia |volume=23 |issue=2 |pages=172–6 |year=2003 |pmid=12778884 |doi= |url=}}</ref>
*Secondary.<ref>URL: [http://www.kidneypathology.com/English_version/Focal_segmental_GS.html http://www.kidneypathology.com/English_version/Focal_segmental_GS.html]. Accessed on: 11 February 2011.</ref>
**HIV.
**Drug use.
**Reduced renal mass.
 
Primary vs. secondary:<ref name=pmid12704572>{{Cite journal  | last1 = D'Agati | first1 = V. | title = Pathologic classification of focal segmental glomerulosclerosis. | journal = Semin Nephrol | volume = 23 | issue = 2 | pages = 117-34 | month = Mar | year = 2003 | doi = 10.1053/snep.2003.50012 | PMID = 12704572 }}
</ref>
{| class="wikitable"
| '''Feature'''
| '''Primary'''
| '''Secondary'''
|-
| Proteinuria (onset)
| sudden
| progressive
|-
| Albumnin
| low
| normal
|-
| Glomerulus size
| normal
| increased
|-
| Foot process effacement
| diffuse
| mild
|}
 
===Microscopic===
Features:
*Partial sclerosis of less than 50% of glomeruli.
 
Image:
*[http://library.med.utah.edu/WebPath/jpeg1/RENAL083.jpg FSGS (utah.edu)].
 
====Histologic classification====
FSGS can be subdivided into the following subgroups:<ref name=pmid16518352>{{Cite journal  | last1 = Thomas | first1 = DB. | last2 = Franceschini | first2 = N. | last3 = Hogan | first3 = SL. | last4 = Ten Holder | first4 = S. | last5 = Jennette | first5 = CE. | last6 = Falk | first6 = RJ. | last7 = Jennette | first7 = JC. | title = Clinical and pathologic characteristics of focal segmental glomerulosclerosis pathologic variants. | journal = Kidney Int | volume = 69 | issue = 5 | pages = 920-6 | month = Mar | year = 2006 | doi = 10.1038/sj.ki.5000160 | PMID = 16518352 }}</ref>
*Cellular.
*Collapsing - poor prognosis.
*Tip lesion - good prognosis.
*Perihilar.
*Not otherwise specified (NOS) - most common.
 
===Stains===
Features:<ref>URL: [http://www.kidneypathology.com/English_version/Focal_segmental_GS.html http://www.kidneypathology.com/English_version/Focal_segmental_GS.html]. Accessed on: 11 February 2011.</ref>
*PAS +ve crescents.
 
==Membranous nephropathy==
===General===
*[[AKA]] ''membranous glomerulonephritis''.
*Presents as nephrotic syndrome.
 
Clinical DDx:<ref>{{Ref Klatt|241}}</ref>
*Hepatitis B.
*Hepatitis C.
*Carcinoma.
*NSAID toxicity.
*SLE.
*Idiopathic.
 
===Microscopic===
Features:
*Subepithelial immune complex depositions, spike forming.
 
Image:
*[http://commons.wikimedia.org/wiki/File:Membranous_Nephropathy_Pathology_Diagram.svg MN - schematic (WC)].


=Mixed nephrotic and nephritic=
=Mixed nephrotic and nephritic=
Michael
48,466

edits

Retrieved from "https://librepathology.org/wiki/Special:MobileDiff/9100"

Navigation menu