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diagnosis differential nephrology rheumatology nephrotic acute aki classification glomerulonephritis injury kidney renal workup hematology management nephritic proteinuria pulmonary testing blood
Vasculitis and Vasculitides - Differential Diagnosis Framework When to Consider Vasculitis: • Purpura, ischemic skin lesions •
tract, and often causes ... - Skin, glomeruli ... Urticaria and hypocomplementemia ... : - Kidneys: glomerular ... against MPO • Complement
Causes of Hypocomplementemia - CHAMPS Mnemonic C - Cryoglobulinemia (85%), C3 glomerulopathy, cirrhosis H - Heavy Chain deposition
Causes of Hypocomplementemia ... antiphospholipid syndrome ... @AnnKumfer #Hypocomplementemia ... #Low #Complement
Nephritic vs Nephrotic Syndrome Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes. Step
Nephritic vs Nephrotic Syndrome ... nephrotic/nephritic syndromes ... the patient have glomerular ... hematuria (RBC casts ... #Comparison #Algorithm
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
of Glomerular Bleeding ... disease - Alport syndrome ... pain hematuria syndrome ... Diagnostic of GN or vasculitis ... • Nutcracker syndrome
Membranoproliferative Glomerulonephritis (MPGN) AKA: Mesangiocapillary GN • Active Urine Sediment (dysmorphic RBC, RBC casts, +/- proteinuria)
dysmorphic RBC, RBC casts ... formation along glomerular ... staining (lg + complement ... MGPN • Complement ... anti-phospholipid syndrome
Rapidly Progressive Glomerulonephritis (RPGN) RPGN has three primary pathophysiologic causes differentiated by immunofluorescence Immune Complex Mediated (granular staining):
pathophysiologic causes ... staining): • Low Complement ... Idiopathic • Normal Complement ... Glomerulonephritis #Vasculitis ... differential #diagnosis #algorithm
Vasculitis - Differential Diagnosis Framework When to Consider Vasculitis: • Purpura, ischemic skin lesions • Mononeuritis multiplex • Hematuria, proteinuria,
• Kidneys: Non-glomerular ... tract, and often causes ... Elevated AST ALT • Hypocomplementemia ... ) • Hypocomplementemic ... • Cogan syndrome
Acute Kidney Injury - Classification Prerenal: • Dehydration • Heart failure (a.k.a. cardiorenal syndrome) • Liver failure
a.k.a. cardiorenal syndrome ... a.k.a. hepatorenal syndrome ... - Small vessel vasculitis ... - TTP/HUS • Glomerular ... tubular necrosis (causes
Cryoglobulinemia Summary Cryoglobulins: • Cryoglobulins are Igs in the serum that precipitate in vitro at temperatures below
• They can cause ... Cryoglobulins Cause ... Hyperviscosity Syndrome ... 20% Sjögren's syndrome ... • Low serum C4 complement
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Differential Diagnosis Algorithm ... • Fanconi's syndrome ... • Drugs Glomerular ... Differential #Diagnosis #Algorithm ... #Causes
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