Glomerulonephritis differential diagnosis

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Glomerulonephritis patient information

Overview

Classification

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Pathophysiology

Differential Diagnosis

Screening

Diagnosis

Prevention

Overview

Differential Diagnosis

Glomerulonephritis Sub-entity Causes and associations History and symtoms Nephrotic features Nephritic features ANCA Anti-glomerular basement membrane antibody (Anti-GBM antibody) Immune complex formation Light microscope Electron microscope Immunoflourescence pattern
Non-proliferative Minimal change disease
  • Idiopathic
  • Protein tyrosine phosphatase receptor type O (glomerular epithelial protein 1- GLEPP1)
  • Young children
  • Recent infection and immunization
  • Atopy
  • Hodgkin lymphoma
  • Thrombosis (due to urinary loss of antithrombin-III)
  • Pitting edema
  • Hyperlipidemia and hyper colesterolemia
+ - - - -
  • Normal
Fusion of podocytes -
Focal segmental glomerulosclerosis
  • Idiopathic
  • HIV
  • Heroine use
  • Sickle cell disease
  • Interferon
  • Severe obesity
  • Mixed cryoglobunemia (Hepatitis C)
  • Adults
  • Pitting edema
  • Hyperlipidemia and hypercolesterolemia
+ - - - -
  • Focal (some glomeruli) and segmental (only part of glomerulus)
  • Effacement of podocytes
Membranous glomerulonephritis
  • Idiopathic
  • Hepatitis B and C
  • Solid tumors
  • Systemic lupus erythmatosus
  • Drugs (NSAIDS, penclliamine, gold, captopril)
  • Pitting edema
  • Hyperlipidemia and hypercolesterolemia
+ - - - +
  • Thick glomerular basement membrance
  • Sub-epithelial immune complex depositis with 'spike and dome' appearance
Proliferative IgA nephropathy
  • Idiopathic
  • Viral infections
  • Young children
  • History of mucosal infections (e.g. gastroenteritis) and upper respiratory tract infection
  • 2-3 days after infection (synpharyngitic)
  • Oliguria
  • Periorbital edema
  • Hypertension
- + - - +
  • Crescent formation
  • Mesangial proliferation
Rapidly progressive glomerulonephritis
  • Goodpasture syndrome
  • Young adults
  • Hemeturia
  • Hemoptysis
  • Oliguria
  • Periorbital edema
  • Hypertension
- + - + + (Linear)
  • Post infectious glomerulonephritis
  • Hemeturia
  • Hemoptysis
  • Streptococcal skin infections
  • Streptococcal pharyngitis
  • 2-3 weeks after infection
  • Oliguria
  • Periorbital edema
  • Hypertension
- + - - +
  • Hypercellular and inflamed glomeruli
  • Sub-epithelial immune complex deposits
+ (granular)
  • Granulomatosis with polyangitis (Wegner's granulomatosis)
  • Hemeturia
  • Hemoptysis
  • Necrotizing granulomas (Nasopharynx, lungs, kidneys)
  • Conjunctivitis
  • Ulceration of the cornea
  • Episcleritis
  • Oliguria
  • Periorbital edema
  • Hypertension
  • Peripheral neuropathy
- + + (C-ANCA) - -
  • Crescent formation
  • Sub-epithelial immune complex deposits
  • Churg Strauss syndrome
  • Hemeturia
  • Hemoptysis
  • Necrotizing granulomas
  • Asthma
  • Oliguria
  • Periorbital edema
  • Hypertension
  • Peripheral neuropathy
- +

+ (C-ANCA)

-
  • Microscopic polyngitis
  • Hemeturia
  • Hemoptysis
  • Necrotizing vasculitis (no granuloma)
  • Oliguria
  • Periorbital edema
  • Hypertension
- +

+ (P-ANCA)

-
Membranoproliferative glomerulonephritis
  • Idiopathic
  • Hepatitis B and C (Type 1)
  • C3 nepritic factor (Type2)
  • Hemeturia
  • Oliguria
  • Periorbital edema
  • Hypertension
+ - - -

References

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