Renal Path 2

Post‑streptococcal GN: timing after infection

1–4 weeks after pharyngitis or impetigo(skin infection)

Post‑streptococcal GN: antigen

Streptococcal exotoxin B

Post‑streptococcal GN: antibody

Anti‑streptolysin O

Post‑streptococcal GN: hypersensitivity type

Type III

RPGN: Anti-GBM Example (duh)

Anti‑GBM antibody mediated. Goodpasture syndrome(AntiGBM disease)

RPGN: Immune Complex Deposition Ex

Immune complex deposition. Post Infectious GN, IgA Nephropathy, Lupus Nephritis

RPGN: ANCA Mediated Small Vessel Vasculitis Ex

ANCA‑mediated small‑vessel vasculitis. GPA, MPA, EGPA

RPGN immunofluorescence Anti GBM Disease

Linear (Anti GBM disease)

RPGN immunofluorescence Immune Complex Mediated

Granular (immune complex mediated)

RPGN immunofluorescence ANCA Mediated vasculitis

No pattern (bc the damage occurs in vasculature)

Cresent cells are seen in

Rapidly Progressive Glomerulonephritis

Membranoproliferative GN (MPGN): syndrome

Mixed nephritic + nephrotic sx. Tram‑track/double contouring. Two types: Immune Complex Mediated and Dense Deposit Disease

Membranoproliferative GN (MPGN) Type I

Immune complex mediated, caused by Hep B/C, endocarditis, SLE, leukemia

Membranoproliferative GN (MPGN) Type II

Dense Deposit Disease»only complement (no immune complexes)»autoantibodies(C3 nephritic factor) bind C3 convertase and prevents its inactivation→constantly active complement system→proliferative inflammation and nephritis

IgA nephropathy: timing vs Post Infectious Glomerulonephritis

Occurs during or immediately after respiratory/GI infection

IgA nephropathy pathogenesis + targeting

Defective IgA1 glycosylation → immune complex formation with IgG against IgA. ALL DAMAGE is MESANGIAL

IgA nephropathy systemic form

Henoch‑Schönlein Purpura (IgA vasculitis)

Membranous nephropathy vs Membranoproliferative GN (MPGN)

Membranous nephropathy: predominately nephrotic syndrome, subEPIthelial deposits, spike and dome appearance

Membranoproliferative GN: mixed nephritic and nephrotic, tram track appearance(double contouring), sub ENDOthelial deposits (makes sense bc nephritic nature)

Hereditary nephritis: collagen (Alport vs thin BM neuropathy)

Alport: Type IV collagen defects (α3, α4, α5)

Thin Basement Membrane: Type IV collagen defects in α3, α4

Alport syndrome triad + Genetics+ EM

Renal failure + sensorineural deafness + ocular defects. X Linked. Basket weaving

ANA means, ANCA means

ANA= Anti-nuclear antibodies
ANCA= Anti-Neutrophil Cytoplasmic antibodies

Lupus nephritis IF

“Full house” (IgG, IgA, IgM, C3, C1q)

Lupus nephritis hallmark lesion

Wire‑loop lesions (subendothelial deposits)

Diabetic nephropathy hallmark lesion

Kimmelstiel‑Wilson nodules (nodular glomerulosclerosis)