Glomerulonephritis

Keywords: GN, Nephritis

Key Information

Appropriate Tests

 

Urinalysis, Protein urine, MCS urine (fresh specimen examined for casts and dysmorphic red cells).

Electrolytes, Creatinine, Urea, eGFR.

Diagnosis is established by Renal biopsy with Immunofluorescence, Immunohistochemistry and Electron microscopy.

The possibility of underlying systemic disease should be considered.

Presentations

 

Haematuria

 

Hypertension

 

Nephritic syndrome

 

Nephrotic syndrome

 

Proteinuria

 

Renal failure

 

Causes

 

Primary renal disease

 

  • IgA nephropathy

 

  • Membranous GN

Phospholipase A2 receptor antibodies.

  • Minimal change disease

 

  • Post-infectious GN

Throat swab, skin lesions - bacterial culture (MCS pus). Antistreptolysin O titre, Anti-deoxyribonuclease B Ab, Complement components C3 and C4.

  • Crescentic GN

Glomerular basement membrane Ab, Antineutrophil cytoplasmic Ab.

  • Dense deposit disease and C3 glomerulopathy 

Complement components C3 and C4, Complement CH50 or CH100, AH50, complement C3 nephritic factor / genetics.

Associated with systemic disease

 

  • SLE

 

  • Goodpasture syndrome

 

  • Vasculitis syndromes, especially
    • Microscopic polyarteritis
    • Granulomatosis with polyangiitis
    • Henoch-Schönlein purpura

See Vasculitis

  • Malignancy

Protein electrophoresis, Free light chains.

Chronic infection-associated GN

 

  • Hepatitis B virus infection

 

  • Hepatitis C virus infection

 

  • Endocarditis (infective)

 

  • Malaria