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diagnosis differential rheumatology pulmonary renal causes cryoglobulinemia cryoglobulins disorders erythematosus gammopathy glomerulonephritis hematology hemoptysis igg4 lymphomas lymphoproliferative management massive mgrs
Rapidly Progressive Glomerulonephritis (RPGN) RPGN has three primary pathophysiologic causes differentiated by immunofluorescence Immune Complex Mediated (granular staining):
Rapidly Progressive ... staining): • Low Complement ... Post-strep GN, Lupus ... Glomerulonephritis #Vasculitis ... differential #diagnosis #algorithm
Vasculitis and Vasculitides - Differential Diagnosis Framework When to Consider Vasculitis: • Purpura, ischemic skin lesions •
proteinuria, rapidly progressing ... inflammation Others: • Lupus ... such as systemic lupus ... against MPO • Complement ... #rheumatology #classification
Pulmonary Renal Syndromes and Mimics - Differential Diagnosis Framework Diffuse alveolar hemorrhage + rapidly progressive glomerulonephritis 90%: -
Diagnosis Framework Diffuse ... hemorrhage + rapidly progressive ... ANCA Associated Vasculitis ... anti-GBM) 10%: - Low Complement ... - Normal Complement
Causes of Hemoptysis - Differential Diagnosis Algorithm Massive Hemoptysis (>I00 mL in 24 hours) • Malignancy •
Differential Diagnosis Algorithm ... • Bronchitis Diffuse ... • Pulmonary Vasculitis ... Malignancy Pulmonary Vasculitis ... • Lupus Erythematosus
SLE (Systemic Lupus Erythematosus) Suspect: Clinical evidence of (fatigue, rash, photosensitivity, inflammatory arthritis, weight loss, and fever) and
anti-Smith Ab, low complements ... Skin Disease Classification ... pneumonitis • Diffuse ... enteropathy, and diffuse ... RNP antibodies, Complement
Cryoglobulinemia Summary Cryoglobulins: • Cryoglobulins are Igs in the serum that precipitate in vitro at temperatures below
• Low serum C4 complement ... • IgA vasculitis ... • Vasculitis ... (e.g. systemic lupus ... diagnosis #types #classification
Lymphomas and Lymphoproliferative Disorders - Differential Diagnosis Algorithm Hodgkin Lymphoma ~40% - Characteristic For Reed-Sternberg (RS) Cells
Differential Diagnosis Algorithm ... system (node) with progression ... lymphadenopathy more diffuse ... Lymphoproliferative #Disorders #Classification ... #differential #algorithm
IGG-4 RELATED DISEASE WHAT? • A chronic, immune-mediated fibroinflammatory disease with tumefactive infiltration of IgG4+ plasma cells
inflammation -> progressive ... aortitis, mimics vasculitis ... - ↑ IgE, ↓ complement ... • Classification
Monoclonal Gammopathy of Renal Significance (MGRS) MGRS • MGRS refers to kidney disease caused by nephrotoxic monoclonal immunoglobulins
guide subtype classification ... tubulopathy) - Complement ... formation causing vasculitis ... function and prevent progression
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