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diagnosis rheumatology differential glomerulonephritis nephrology management nephrotic rpgn testing workup champs cryoglobulins disease erythematosus gammopathy hematology igg4 initial large low
Cryoglobulinemia Summary Cryoglobulins: • Cryoglobulins are Igs in the serum that precipitate in vitro at temperatures below
Cryoglobulinemia ... Types: • Type ... • Low serum C4 complement ... • Vasculitis ... #classification
Causes of Hypocomplementemia - CHAMPS Mnemonic C - Cryoglobulinemia (85%), C3 glomerulopathy, cirrhosis H - Heavy Chain deposition
Causes of Hypocomplementemia ... Mnemonic C - Cryoglobulinemia ... glomerulonephritis, type ... 1 (50%-80%), type ... #Low #Complement
Vasculitis and Vasculitides - Differential Diagnosis Framework When to Consider Vasculitis: • Purpura, ischemic skin lesions •
ANCA +MPO) • Cryoglobulinemic ... , glomeruli, and ... : - Kidneys: glomerular ... against MPO • Complement ... #rheumatology #classification
Rapidly Progressive Glomerulonephritis (RPGN) - Loss of kidney function over a short period of tirne
with evidence of glomerular ... immune deposits in glomeruli ... lupus nephritis, cryoglobulinemia ... autoAb against type ... Glomerulonephritis #RPGN #Classification
Vasculitis - Break down based on vessel size Distribution of vessel involvement by large vessel vasculitis,
Vasculitis - Break ... by large vessel vasculitis ... can affect any type ... Anti-GBM = anti–glomerular ... Medium #Large #Classification
Rapidly Progressive Glomerulonephritis (RPGN) RPGN has three primary pathophysiologic causes differentiated by immunofluorescence Immune Complex Mediated (granular staining):
staining): • Low Complement ... Lupus Nephritis, Cryoglobulinemia ... Idiopathic • Normal Complement ... Glomerulonephritis #Vasculitis ... differential #diagnosis #algorithm
Recommended initial testing for patients being evaluated for glomerular disease 24-hour urine collection - Quantify proteinuria.
evaluated for glomerular ... or alternative complement ... for ANCA-related vasculitis ... factor - Screen for cryoglobulinemias ... (types 2 and 3)
Recommended initial testing for patients being evaluated for glomerular disease 1) 24-hour urine collection - Quantify proteinuria.
evaluated for glomerular ... or alternative complement ... for ANCA-related vasculitis ... factor - Screen for cryoglobulinemias ... (types 2 and 3)
Vasculitis - Differential Diagnosis Framework When to Consider Vasculitis: • Purpura, ischemic skin lesions • Mononeuritis multiplex • Hematuria, proteinuria,
Vasculitis - Differential ... • Kidneys: Non-glomerular ... / ANCA + MPO) Cryoglobulinemic ... Elevated AST ALT • Hypocomplementemia ... ) • Hypocomplementemic
Sjogren's Syndrome Overview Epidemiology: • F > M: 9:1 • 5-6th Decades (can be any age) Autoimmune exocrinopathy multisystemic disease
Cytopenia: 2% • Hypocomplementemia ... IV RTA, TYPE I ... ) • Cutaneous vasculitis ... : 2% Systemic Vasculitis ... : • 7%, Cryoglobulinemia
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