Rapidly progressive glomerulonephritis laboratory findings: Difference between revisions
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* Serum [[protein electrophoresis]] | * Serum [[protein electrophoresis]] | ||
[[Anemia]] | '''Laboratory findings''' | ||
* [[Anemia]] , mostly due to impaired production of [[erythropoietin]] by kidneys. or [[Gastrointestinal bleeding|GI bleeding]]. | |||
* [[Eosinophilia]] is usually seen in patients with [[Churg-Strauss syndrome|Churg-Strauss disease]]. | |||
* Patients with RPGN may show formation of [[immune complexes]] and [[cryoglobulins]]. | |||
* [[Complement|Complement C3]] levels is usually low in immune-complex mediated RPGN. | |||
* The presence of [[ANCA]] and [[Anti-GBM antibody|anti-GBM]] is variable. | |||
* [[ANCA]]-associated [[glomerulonephritis]] have high levels of [[ANCA]], it is associated with disease activity.<ref name="pmid2857806">{{cite journal| author=van der Woude FJ, Rasmussen N, Lobatto S, Wiik A, Permin H, van Es LA et al.| title=Autoantibodies against neutrophils and monocytes: tool for diagnosis and marker of disease activity in Wegener's granulomatosis. | journal=Lancet | year= 1985 | volume= 1 | issue= 8426 | pages= 425-9 | pmid=2857806 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2857806 }} </ref><ref name="pmid2684074">{{cite journal| author=Tervaert JW, van der Woude FJ, Fauci AS, Ambrus JL, Velosa J, Keane WF et al.| title=Association between active Wegener's granulomatosis and anticytoplasmic antibodies. | journal=Arch Intern Med | year= 1989 | volume= 149 | issue= 11 | pages= 2461-5 | pmid=2684074 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2684074 }} </ref><ref name="pmid2221646">{{cite journal| author=Falk RJ, Hogan S, Carey TS, Jennette JC| title=Clinical course of anti-neutrophil cytoplasmic autoantibody-associated glomerulonephritis and systemic vasculitis. The Glomerular Disease Collaborative Network. | journal=Ann Intern Med | year= 1990 | volume= 113 | issue= 9 | pages= 656-63 | pmid=2221646 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2221646 }} </ref> | |||
* [[ESR]] and [[CRP]] may be elevated and indicate inflammation and activity of the disease. | |||
[[ESR]] and [[CRP]] may be elevated and | |||
===Urine Work-Up=== | ===Urine Work-Up=== | ||
Revision as of 13:50, 24 July 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
Laboratory Findings
Blood Work-Up
- Complete blood count (CBC)
- Serum electrolytes
- Lactate dehydrogenase (LDH)
- Creatine phosphokinase (CPK)
- Antinuclear antibody (ANA)
- Complement C3 and C4 levels
- Serum protein electrophoresis
Laboratory findings
- Anemia , mostly due to impaired production of erythropoietin by kidneys. or GI bleeding.
- Eosinophilia is usually seen in patients with Churg-Strauss disease.
- Patients with RPGN may show formation of immune complexes and cryoglobulins.
- Complement C3 levels is usually low in immune-complex mediated RPGN.
- The presence of ANCA and anti-GBM is variable.
- ANCA-associated glomerulonephritis have high levels of ANCA, it is associated with disease activity.[1][2][3]
Urine Work-Up
- Urinalysis
- Urinary protein electrophoresis
- Patients with RPGN do not usually have a full-blown picture of nephrotic syndrome; Nephrotic syndrome only occurs in less than 30% of cases.[4]
- Proteinuria, if present, is usually mild to moderate. Hematuria of glomerular type with dysmorphic red blood cells is usually present on urinalysis and associated with red cell casts.
- Mild to moderate leukocyturia may be seen and other casts, such as epithelial cell leukocyte, or fatty casts. Urinary findings in RPGN are important features that not only favor diagnostic work-up, but also follow-up and therapeutic effectiveness.
References
- ↑ van der Woude FJ, Rasmussen N, Lobatto S, Wiik A, Permin H, van Es LA; et al. (1985). "Autoantibodies against neutrophils and monocytes: tool for diagnosis and marker of disease activity in Wegener's granulomatosis". Lancet. 1 (8426): 425–9. PMID 2857806.
- ↑ Tervaert JW, van der Woude FJ, Fauci AS, Ambrus JL, Velosa J, Keane WF; et al. (1989). "Association between active Wegener's granulomatosis and anticytoplasmic antibodies". Arch Intern Med. 149 (11): 2461–5. PMID 2684074.
- ↑ Falk RJ, Hogan S, Carey TS, Jennette JC (1990). "Clinical course of anti-neutrophil cytoplasmic autoantibody-associated glomerulonephritis and systemic vasculitis. The Glomerular Disease Collaborative Network". Ann Intern Med. 113 (9): 656–63. PMID 2221646.
- ↑ Hricik DE, Chung-Park M, Sedor JR (1998). "Glomerulonephritis". N Engl J Med. 339 (13): 888–99. doi:10.1056/NEJM199809243391306. PMID 9744974.