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diagnosis differential rheumatology vasculitis anca syndromes acute aki algorithm ana antibodies antibody antigbm antineutrophil antinuclear associated autoantibodies basement canca causes
Pulmonary Renal Syndrome Definition: Diffuse alveolar hemorrhage + Glomerulonephritis Presentation (Pulmonary and renal manifestations can occur weeks apart):
Pulmonary Renal ... Peripheral edema, Disease-specific ... vasculitis, Behcet disease ... Goodpasture's Disease ... ab, anti-GBM ab
Summary of characteristic abnormalities of selected glomerular diseases Light Microscopy (LM) - Immunofluorescence Microscopy (IM) - Electron
selected glomerular diseases ... Microscopy (EM) ... Minimal change disease ... Amyloid RPGN • Anti-GBM ... #glomerular #diseases
Systemic Sclerosis Associated Autoantibodies Anti-topoisomerase I (anti-Sc170): Diffuse skin disease, Pulmonary fibrosis Anti-centromere: Limited skin disease (~93-95%), Pulmonary
Diffuse skin disease ... , Pulmonary fibrosis ... : Limited skin disease ... III: Diffuse, Renal ... , Overlap BCM IM
ANA (Antinuclear Antibody) and ANCA (Antineutrophil cytoplasmic antibodies) • Systemic lupus erythematosus 1. Anti-dsDNA
connective tissue disease ... Vasculitis: • Microscopic ... ANCA+ 90% • Anti-GBM ... disease - MPO>PR3 ... #rheumatology #diseases
Pulmonary Renal Syndromes and Mimics - Differential Diagnosis Framework Diffuse alveolar hemorrhage + rapidly progressive glomerulonephritis 90%: -
Pulmonary Renal ... Vasculitis - Anti-GBM ... Disease - Double ... Positive (ANCA + anti-GBM ... , mitral valve disease
Acute Kidney Injury (AKI) - Differential Diagnosis Framework PRE-Renal AKI: • Hypovolemia • Congestion • Medications •
Framework PRE-Renal ... Immune-complex disease ... , Anti-GBM • Tubular ... Bilateral ureteral disease ... Differential #Diagnosis #nephrology
Pulmonary Renal Syndromes - OnePager Summary Autoimmune ANCA vasculitis (AAV): GPA (granulomatous with polyangiitis), EGPA (eosinophilic granulomatosis
Pulmonary Renal ... life-threatening diseases ... Inflammatory eye disease ... ANCA antibody, Anti-GBM ... usually low in anti-GBM
ANCA-Associated Vasculitis A group of necrotizing, small-vessel vasculitis without immune complex deposition. Complement levels are normal due
polyangiitis (GPA), microscopic ... polyangiitis without renal ... involvement - PR3>MPO Microscopic ... 90%, rarely PR3 Anti-GBM ... disease - MPO>PR3
Vasculitis and Vasculitides - Differential Diagnosis Framework When to Consider Vasculitis: • Purpura, ischemic skin lesions •
glomerulonephritis) • Anti-GBM ... disease, and ocular ... (Granulomatous disease ... atherosclerotic disease ... most important diseases
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
proliferative • Anti-GBM ... polyangiitis (GPA) / microscopic ... Minimal change disease ... #Proteinuria #Nephrology
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