And review of acute nephritis syndromes
1 / 10

karyomegalic tubulointerstitial Nephritis - PowerPoint PPT Presentation

  • Uploaded on

And Review of Acute nephritis Syndromes. karyomegalic tubulointerstitial Nephritis. Karyomegalic Tubulointerstitial Nephritis. Symptoms: Recurrent Pneumonias Renal failure leading invariably to ESRD Hypertension Hematuria Typically patients present in third decade of life.

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

PowerPoint Slideshow about ' karyomegalic tubulointerstitial Nephritis' - ramona

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
And review of acute nephritis syndromes

And Review of Acute nephritis Syndromes

karyomegalic tubulointerstitial Nephritis

Karyomegalic tubulointerstitial nephritis
KaryomegalicTubulointerstitial Nephritis

  • Symptoms:

    • Recurrent Pneumonias

    • Renal failure leading invariably to ESRD

    • Hypertension

    • Hematuria

    • Typically patients present in third decade of life.

Karyomegalic tubulointerstitial nephritis1
KaryomegalicTubulointerstitial Nephritis

  • Clinical features:

    • Negative seriologies for autoimmune and viral causes

    • Pathology shows:

      • Interstitial fibrosis

      • Large nuclei in proximal tubular cells with odd shape and focal intra-nuclear clearing

      • Negative for immunoflorescence

      • Irregular nuclear membranes on electron microscopy

Karyomegalic tubulointerstitial nephritis2
KaryomegalicTubulointerstitial Nephritis

  • Etiology: believed to be secondary to a mitotic block

  • Associated with HLA A9/B35 genotype

  • Viral Etiologies have mostly been debunked due to negative seriologies

  • Chemical exposure is not a consistent trademark

Acute nephritis syndromes
Acute Nephritis Syndromes

  • Post Strep GN:

    • Happens after skin or throat infection with Beta hemolytic Strep particulary type M, 1-3 weeks after throat or 2-6 weeks after skin infection

    • Acute endocapillaryproliferatie GN

  • Dx: symptoms of hematuria, edema, nephrotic range proteinuria, headache, hypertension, oliguria

    • Antistrep antibodies positive

    • Renal biopsy showing PMNs, glomerular immune deposits of IGG, IGM, C3, C4, and C5-9 (humps)

  • Rx: supportive.

Acute nephritis syndromes1
Acute Nephritis Syndromes

  • Lupus nephritis:

    • Symptoms: hematuria, hypertension, renal failure

    • WHO classifications:

      • I: normal

      • II: mesanigal immune complexes with mesangial proliferation

      • III- IV: focal to global diffuse proliferative disease

        • III: steroids, IV: steroids mycofenalate or cyclophosphamide.

      • V: bubendothelial immune deposits (membranous pattern,

        • -steroids

  • Remember: full house: of IG’s and positive Anti-ds DNA antibodies.

Acute nephritis syndromes2
Acute Nephritis Syndromes

  • Anti Basement membrane disease

    • Hemorrhage and glomerulonephritis, oliguria

      • Associated with pulmonary hemorrhage (goodpastures disease)

    • DX: Anti-GMB antibodies (IgG rarely IgA)

      • Biopsy with smooth glomerular staining.

      • ANCAs may be positive with goodpastures syndrome (myeloperoxidase

    • Rx: Plasmapheresis, steroids,

Acute nephritis syndromes3
Acute Nephritis Syndromes

  • IgA Nephropathy

    • Dx: <20 years old typically, preceding infection, hematuria, Deposition of IgA in mesangium.

      • One of most common GN worldwide

      • Common in asians and souther europeans (30 and 20% prevalance respectively)

    • Rx: ACE inhibitors, tonsilectomy, steroids,

      • If RPGN: steroids, cytotoxic agents, plasmapheresis


  • Harrisons internal medicine

  • Baba et al, karyomegalic tubulointerstital nephritis – a case report, Pathology, research and practice, 202 2006 555-559.