Nephrology - cold

Question 1

Causes

Granular appearance on immunofluorescence

Answer 1

Granular appearance on immunofluorescence

• SLE nephropathy (class IV)
• post-streptococcal glomerulonephritis

Question 2

Causes

Secondary causes of minimal change disease

Answer 2

Secondary causes of minimal change disease

• Drugs-NSAIDs; rarely other drugs, such as lithium
• Lymphoma-both Hodgkin’s and non-Hodgkin lymphoma (NHL)

Question 3

Causes

Membranous glomerulonephritis

Answer 3

Membranous glomerulonephritis

• idiopathic
• infections:
  
  • hepatitis B,
  • malaria,
  • syphilis
• malignancy:
  
  • lung cancer,
  • lymphoma,
  • leukaemia
• drugs:
  
  • gold,
  • penicillamine,
  • NSAIDs
• autoimmune diseases:
  
  • systemic lupus erythematosus (class V disease),
  • thyroiditis,
  • rheumatoid

Medstudy

• Chronic infections (primarily chronic HBV but also malaria)
• Drugs e.g., NSAIDs, penicillamine, gold, anti-TNF agents (e.g. infliximab)
• Solid tumors (Tumors are usually obvious but if not, do age-appropriate malignancy screening.)
• Autoimmune diseases (e.g., thyroiditis, rheumatoid arthritis (RA), SLE [consider if MN presents in a young female])

Question 4

Causes

Focal segmental glomerulosclerosis (FSGS)

Answer 4

Focal segmental glomerulosclerosis (FSGS)

• idiopathic
• secondary to other renal pathology e.g. IgA nephropathy, reflux nephropathy
• HIV
• heroin
• Alport’s syndrome
• sickle-cell

Medstudy

• HIV/AIDS,
• heroin use,
• bisphosphonates, anabolic steroids, and interferon
• obesity,
• sickle cell disease, or
• chronic vesicoureteral reflux.
• Diabetes and hypertension are also associated with secondary FSGS.

Question 5

Causes

Causes of Fanconi syndrome

Answer 5

Causes of Fanconi syndrome

• cystinosis (most common cause in children)
• Sjogren’s syndrome
• multiple myeloma
• nephrotic syndrome
• Wilson’s disease