Difference between revisions of "Medical kidney diseases"

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218 bytes removed ,  02:37, 23 November 2011
→‎Rare diseases: merge AGBM & Goodpasture disease
(→‎Rare diseases: merge AGBM & Goodpasture disease)
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*Abbreviated ''AGBM''.
*Abbreviated ''AGBM''.
===General===
===General===
*Known as '''Goodpasture disease''' and '''Goodpasture syndrome''' if renal failure is accompanied by pulmonary hemorrhage.<ref>{{cite journal | author=Goodpasture EW | title=The significance of certain pulmonary lesions in relation to the etiology of influenza | journal=Am J Med Sci | year=1919 | volume=158 | pages=863–870 | doi=10.1097/00000441-191911000-00012 | issue=6}}</ref>
*Rare - estimated incidence 1/1-2 million.<ref name=pmid20962523/>
*Rare - estimated incidence 1/1-2 million.<ref name=pmid20962523/>
*[[Antibody mediated hypersensitivity]].
*[[Antibody mediated hypersensitivity]].
Line 698: Line 699:
**Antibodies directed against COL4A3,<ref>{{OMIM|120070}}</ref> which is ''not'' mutated.
**Antibodies directed against COL4A3,<ref>{{OMIM|120070}}</ref> which is ''not'' mutated.


===Microscopic===
Tx:
Features:
*Immune suppression & plasma exchange.<ref name=pmid12597309>{{Cite journal | last1 = Shah | first1 = MK. | last2 = Hugghins | first2 = SY. | title = Characteristics and outcomes of patients with Goodpasture's syndrome. | journal = South Med J | volume = 95 | issue = 12 | pages = 1411-8 | month = Dec | year = 2002 | doi = | PMID = 12597309 }}</ref>
*[[RPGN]].
**Crescentic glomerulonephritis.
 
===IF===
*Linear IgG deposits - '''diagnostic'''.
 
DDx:
*[[Goodpasture syndrome]] - has pulmonary hemorrhage.
 
==Goodpasture syndrome==
*[[AKA]] Goodpasture disease.
===General===
*Very rare - estimated incidence 1/1-2 million.
*Renal failure and pulmonary hemorrhage.<ref>{{cite journal | author=Goodpasture EW | title=The significance of certain pulmonary lesions in relation to the etiology of influenza | journal=Am J Med Sci | year=1919 | volume=158 | pages=863–870 | doi=10.1097/00000441-191911000-00012 | issue=6}}</ref>


Clinical DDx:
Clinical DDx:
*[[Wegener granulomatosis]].
*[[Wegener granulomatosis]].
*Azathioprine toxicity.<ref>{{Cite journal  | last1 = Stetter | first1 = M. | last2 = Schmidl | first2 = M. | last3 = Krapf | first3 = R. | title = Azathioprine hypersensitivity mimicking Goodpasture's syndrome. | journal = Am J Kidney Dis | volume = 23 | issue = 6 | pages = 874-7 | month = Jun | year = 1994 | doi =  | PMID = 8203372 }}</ref>
*Azathioprine toxicity.<ref name=pmid8203372>{{Cite journal  | last1 = Stetter | first1 = M. | last2 = Schmidl | first2 = M. | last3 = Krapf | first3 = R. | title = Azathioprine hypersensitivity mimicking Goodpasture's syndrome. | journal = Am J Kidney Dis | volume = 23 | issue = 6 | pages = 874-7 | month = Jun | year = 1994 | doi =  | PMID = 8203372 }}</ref>
 
Tx:
*Immune suppression & plasma exchange.<ref name=pmid12597309>{{Cite journal  | last1 = Shah | first1 = MK. | last2 = Hugghins | first2 = SY. | title = Characteristics and outcomes of patients with Goodpasture's syndrome. | journal = South Med J | volume = 95 | issue = 12 | pages = 1411-8 | month = Dec | year = 2002 | doi =  | PMID = 12597309 }}</ref>


===Microscopic===
===Microscopic===
Features:
Features:
*RPGN.
*[[RPGN]].
**Crescentic glomerulonephritis.
**Crescentic glomerulonephritis.


===IF===
===IF===
*Linear IgG deposits - '''key feature'''.
*Linear IgG deposits - '''diagnostic'''.


DDx:
DDx:
*AGBM disease.
*Goodpasture syndrome with the pulmonary hemorrhage.
**Goodpasture syndrome without the pulmonary hemorrhage.


==Thin glomerular basement membrane disease==
==Thin glomerular basement membrane disease==
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