GLOMERULONEPHRITIS
This is a Kidney
condition where there’s inflammation and proliferation of glomeruli 20
to immunological injury.
VARIETIES:
Acute Glomerulonepheritis (A G N): it has a good prognosis.
Rapidly Progressive glomerulonepheritis: Normally leads to death.
Chronic glomerulonepheritis: pregnancy tests suffers prolonged
morbidity and later mortality.
AETIOLOGY:
It can be Familial. The commonest is
Alpot’s syndrome that normally presents
of nerve deafness.
Post infection GN: This results from infection of formation of antigen-
antibody complex. That is deposited on the Kidney of Complements attaching to
them leading to immune complex formation deposited on the basement membrane and
thus causing damage. E.g of bacteria infections that cause this are strep,
E.coli, T. pallidum and M. leprae.
Parasites like P. Falciparun,
Schistosomiasis
Viruses like Hepatitis. B measles mumps.
Metabolic causes like DM.
Toxins like carbon tetrachloride, Bea sting. Other conditions like
analgesics, P C M, Shunts e.g Veritriculo- peritoneal shunts usually occurs in
children of hydrocephalus.
ACUTE GLOMERULONEPHERITIS: A nephritis
xtenzal by haematuna, oliguria, oedema, HTN+/- Azothermia.
AETIOLOGY: Nephrogenic stain from the
kidney of lancefield group A, B hemolytic strept. This happens by antigen-
antibody intraction of complement attaching to it and leading to immune complex
4matri and deposition on the basement membrane. This stimulates a cascade of
events that destroys the glomenilus. This usually follows infections of the
skin (the commonest form in Africa ) or the
pharynx by streptococcal organisms usually 2weeks afterwards.
EPIDEMIOLOGY: Occurs at any age but the peak age in Nigeria is 5-8years it is
becoming associate of under development as incidence is dropping in the
developed world.
CLINICAL FEATURES:
Periorbital fullers mostly worse in the morning.
ATYpical Presentations:
Haematuna alone
Proteinuria alone or
^d B F
Oliguna
Acute Renal Failure
HTN have Escephalopathy
Here, pregnancy test doesn’t have to present of all of the above. It
may present of 2 or 2
Classical Presentations include:
Haematuria
Oliguria
Leukocytouria
HTN
Oedema
Electrolyte disturbance.
INVESTIGATIONS:
FBC,
Hb (bw or normal)
WBC (often high)
Throat swab for MCS
ASO-titre –usually ^d in strep throat infection(phamyngitis) but rarely
raised when AGN results from skin infection.
Se/E/u/Cr- Mild derangement
Urinalysis – Urine is scanty also.
Specific gravity may be high.
Protein may be + or ++
RBC is high
WBC is high
Small granular Cast.
Tx:
It is essential to monitor input and output.
Intake= 250ml/m2+ the quality of urine produced by p
x in the last 24hours..
Restrict salt if BP is high
Antibiotic
of penicillin G or depot penicillin.
Diuretic given only in oedema
If HTN is mild, give bed rest while in moderate to severe give
antihypertensives.
COMPLICATIONS:
ARF
HTN have encephalopathy
PROGNOSIS:
95%
will have resolution in 2-4weeks complete resolution of proteinuria may take up
to 6weeks.
2% may die in ARF and 3% will enter into chronic stage out of which
good no will develop. CRF or Nephrotic Syndrome.
Loading...
July 07, 2015
Tags :
NEWS
Subscribe by Email
Follow Updates Articles from This Blog via Email
No Comments