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diagnosis differential algorithm renal vasculitis glomerulonephritis anca antibodies antibody antigbm antineutrophil antinuclear basement classification comparison disease glomerular goodpastures hematuria management
Summary of characteristic abnormalities of selected glomerular diseases Light Microscopy (LM) - Immunofluorescence Microscopy (IM) - Electron
(IM) - Electron ... Microscopy (EM) ... Amyloid RPGN • Anti-GBM ... polyangiitis #glomerular ... #diseases #nephrology
Pulmonary Renal Syndrome Definition: Diffuse alveolar hemorrhage + Glomerulonephritis Presentation (Pulmonary and renal manifestations can occur weeks apart):
polyangiitis, Microscopic ... sclerosis • Anti-Glomerular ... testing: anti-ANCA ... ab, anti-GBM ab ... , ANA, C3, C4, anti-CCP
Causes of Hematuria - Differential Diagnosis Algorithm Red blood cells on urine microscopy. Must exclude false positives
Causes of Hematuria ... cells on urine microscopy ... disease • ... wall) • Anti-GBM ... • Pauci-immune disease
ANA (Antinuclear Antibody) and ANCA (Antineutrophil cytoplasmic antibodies) • Systemic lupus erythematosus 1. Anti-dsDNA
ANA (Antinuclear ... Vasculitis: • Microscopic ... + 90% • Anti-GBM ... Jcortesizaguirr #ANA ... antibodies #diagnosis #rheumatology
Anti-GIomeruIar Basement Membrane Disease (Goodpasture's Disease) What is it? A small vessel vasculitis with circulating antibodies directed
Anti-GIomeruIar ... Diagnosis: • Anti-GBM ... weeks By Tess Litchman ... AntiGBM #diagnosis #nephrology ... #pulmonary
Rapidly Progressive Glomerulonephritis (RPGN) RPGN has three primary pathophysiologic causes differentiated by immunofluorescence Immune Complex Mediated (granular staining):
pathophysiologic causes ... Henoch-SchonIein Purpura Anti-GBM ... Limited to Kidney: Anti-GBM ... involvement: Anti-GBM ... Disease (Goodpasture's
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Causes of Proteinuria ... proliferative • Anti-GBM ... polyangiitis (GPA) / microscopic ... Minimal change disease ... #Proteinuria #Nephrology
Pulmonary Renal Syndromes - OnePager Summary Autoimmune ANCA vasculitis (AAV): GPA (granulomatous with polyangiitis), EGPA (eosinophilic granulomatosis
life-threatening diseases ... Inflammatory eye disease ... antibody, Anti-GBM ... usually low in anti-GBM ... Goodpasture's cause
Vasculitis and Vasculitides - Differential Diagnosis Framework When to Consider Vasculitis: • Purpura, ischemic skin lesions •
): • Microscopic ... often causes arthritis ... glomerulonephritis) • Anti-GBM ... Dx: GPA, EGPA, microscopic ... differential #diagnosis #rheumatology
Membranoproliferative Glomerulonephritis (MPGN) AKA: Mesangiocapillary GN • Active Urine Sediment (dysmorphic RBC, RBC casts, +/- proteinuria)
dysmorphic RBC, RBC casts ... (Dense deposit disease ... immune deposits on EM ... microangiopathy (TMA), anti-phospholipid ... Glomerulonephritis #MPGN #nephrology
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