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diagnosis differential nephrology rheumatology classification pulmonary renal types workup allergy disease hypersensitivity management nephrotic pathophysiology reactions syndrome syndromes testing acute
Vasculitis and Vasculitides - Differential Diagnosis Framework When to Consider Vasculitis: • Purpura, ischemic skin lesions •
- Skin, glomeruli ... often involved • Hypocomplementemic ... Urticaria and hypocomplementemia ... : - Kidneys: glomerular ... against MPO • Complement
Pathophysiology of Hypocomplementemic Urticarial Vasculitis C1q/anti-C1q antibiody -> Immune Complex Formation - Complement Pathway Activation (C3a and C5a)
Pathophysiology of Hypocomplementemic ... Urticarial Vasculitis ... Complex Formation - Complement ... Formation -> Vasculitis ... TerrierBen #Hypocomplementemic
Causes of Hypocomplementemia - CHAMPS Mnemonic C - Cryoglobulinemia (85%), C3 glomerulopathy, cirrhosis H - Heavy Chain deposition
Causes of Hypocomplementemia ... Membranoproliferative glomerulonephritis ... Post/pauci immune glomerulonephritis ... @AnnKumfer #Hypocomplementemia ... #Low #Complement
Membranoproliferative Glomerulonephritis (MPGN) AKA: Mesangiocapillary GN • Active Urine Sediment (dysmorphic RBC, RBC casts, +/- proteinuria)
Membranoproliferative Glomerulonephritis ... formation along glomerular ... staining (lg + complement ... MGPN • Complement ... Membranoproliferative #Glomerulonephritis
Rapidly Progressive Glomerulonephritis (RPGN) RPGN has three primary pathophysiologic causes differentiated by immunofluorescence Immune Complex Mediated (granular staining):
Rapidly Progressive Glomerulonephritis ... staining): • Low Complement ... Idiopathic • Normal Complement ... Kidney: Anti-GBM Glomerulonephritis ... #Vasculitis #differential
Pulmonary Renal Syndromes and Mimics - Differential Diagnosis Framework Diffuse alveolar hemorrhage + rapidly progressive glomerulonephritis 90%: -
rapidly progressive glomerulonephritis ... ANCA Associated Vasculitis ... anti-GBM) 10%: - Low Complement ... - Normal Complement ... Renal Crisis, IgA Vasculitis
Vasculitis - Differential Diagnosis Framework When to Consider Vasculitis: • Purpura, ischemic skin lesions • Mononeuritis multiplex • Hematuria, proteinuria,
• Kidneys: Non-glomerular ... , pauci-immune glomerulonephritis ... (Glomerulonephritis ... Elevated AST ALT • Hypocomplementemia ... ) • Hypocomplementemic
Recommended initial testing for patients being evaluated for glomerular disease 24-hour urine collection - Quantify proteinuria.
evaluated for glomerular ... monitoring low-level glomerular ... or alternative complement ... for ANCA-related vasculitis ... workup #diagnosis #glomerulonephritis
Pulmonary Renal Syndrome Definition: Diffuse alveolar hemorrhage + Glomerulonephritis Presentation (Pulmonary and renal manifestations can occur weeks apart):
alveolar hemorrhage + Glomerulonephritis ... ANCA-positive vasculitis ... ANCA-negative vasculitis ... IgA-associated vasculitis ... sclerosis • Anti-Glomerular
Acute Kidney Injury - Classification Prerenal: • Dehydration • Heart failure (a.k.a. cardiorenal syndrome) • Liver failure
- Small vessel vasculitis ... - TTP/HUS • Glomerular ... Post-infectious glomerulonephritis
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