肾小球疾病知识介绍.ppt

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肾小球疾病知识介绍.ppt

It’s Clearly a case Of carcinoma related Membranous nephropathy ! Pathology PAS MASSON HE PASM Pathological classification of GN 轻微病变性肾小球肾炎minimal change glomerulonephritis 局灶节段性病变 focal segmental lesions 弥漫性肾小球肾炎 diffuse glomerulonephritis 膜性肾病 membranous nephropathy 增生性肾炎 proliferative glomerulone-phritis 硬化性肾炎 sclerosing glomerulonephritis 未分类性肾小球肾炎 unclassified glomerulo-nephritis 增生性肾炎 proliferative glomerulone-phritis 系膜增生性肾小球肾炎 mesangial proliferative GN 毛细血管内增生性肾小球肾炎 endocapillary proliferative GN 系膜毛细血管内增生性肾小球肾炎 mesan-gial capillary GN 新月体肾炎 crecentic GN Pathological classification of GN Clinical syndromes of glomerular diseases Asymptomatic hematuria/ or proteinuria Nephrotic syndrome Acute glomerular nephritis Rapidly progressive glomerular nephritis Chronic glomerular nephritis Asymptomatic hematuria/ or proteinuria Latent nephritis Mild chronic GN or recovery phase of acute GN Isolated microscopic hematuria (Dysmorphic RBC) Isolated proteinuria No HBP, edema or Azotemia Treatment is similar to chronic GN CASE I 11 year-old male History: Intermittent hematuria x 1 year Hx of recurrent pharyngitis Physical: tonsillitis Urinalysis: 15 RBC/HPF 1 ? protein RBC casts Lab Data: dysmorphic RBC HE PAS IgA The Patient Has IgA nephropathy! IgA Nephropathy Most common GN Mesangioproliferative or other pathological types Predominent mesangial IgA deposit Persistent or episode of hematuria Exacerbate on infection 1/3 have elevated serum IgA Clinical syndromes of glomerular diseases Asymptomatic hematuria/ or proteinuria Nephrotic syndrome Acute glomerular nephritis Rapidly progressive glomerular nephritis Chronic glomerular nephritis Nephrotic Syndrome Insidious onset Manifestations Proteinuria 3.5g/d Hypoalbuminemia alb 30 g/l Edema Hyperlipidemia

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