Staphylococcus-associated GlomeruloNephritis - Diagnosis and Management Summary
CLINICAL
• Nephritic syndrome (Casts)
• Marked proteinuria (may be nephrotic range)
• Often severe renal impairment
• 15% macroscopic haematuria
• Leukocyturia
• Vasculitic rash not uncommon
DIAGNOSIS
• 80% ↓ C3 or CH50
• ± ↓ C4
• Microbial cultures
• No serologic tests available
• Renal biopsy
HISTOPATHOLOGY
• Spectrum of abnormalities
• Endocapillary exudative GN
• C3/lgG or IgA (esp DM)
• "starry sky"
• Sub-epithelial humps
• Sub-endothelial deposits common
TREATMENT
• Supportive care
• Antibiotics / source control
- Pivotal in management
- Surgery if needed
• No role for IS
• Resolution may take months
Follow-up:
• CKD not uncommon
• Unmasked C3GN rare
Dr. John Booth @ThePeanutKidney
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