Basics of Glomerulonephritis (GN). GBM is key.
All patterns can be explained by glomerular basement membrane (GBM) & type of injury.
Let’s do one at a time
CRESCENTIC GN
1. Results from breach/break of GBM (red arrow)
2. Injury is sudden & severe
Eg-ANCA & anti-GBM GN x.com
All patterns can be explained by glomerular basement membrane (GBM) & type of injury.
Let’s do one at a time
CRESCENTIC GN
1. Results from breach/break of GBM (red arrow)
2. Injury is sudden & severe
Eg-ANCA & anti-GBM GN x.com
DIFFUSE proliferative GN
GBM stays INTACT!
1. Massive injury but GBM holds ground!
2. Injury usually from large subendothelial immune complexes/complement deposits
3. Leukocytes come in to remove the deposits: DPGN pattern
Lupus, infections, cryoglobulins
Note: intact GBM x.com
GBM stays INTACT!
1. Massive injury but GBM holds ground!
2. Injury usually from large subendothelial immune complexes/complement deposits
3. Leukocytes come in to remove the deposits: DPGN pattern
Lupus, infections, cryoglobulins
Note: intact GBM x.com
Membranoproliferative GN (MPGN)
1. Original GBM stays INTACT
2. + New GBM made, entrapping immune/complement
3. Results in 2 GBM: original & new= double contour
4. Double contour results in ⬇️ leukocytes=⬇️ inflammation
Seen in chronic disease:hepatitis, monoclonal Ig, C3G x.com
1. Original GBM stays INTACT
2. + New GBM made, entrapping immune/complement
3. Results in 2 GBM: original & new= double contour
4. Double contour results in ⬇️ leukocytes=⬇️ inflammation
Seen in chronic disease:hepatitis, monoclonal Ig, C3G x.com
Mesangial proliferative GN
1. GBM stays intact
2. Mesangium acts as sieve
3. Ig, complement, with affinity for mesangial matrix
4. Low grade injury, can be progressive
5. Leukocytes cannot penetrate mesangium. So mesangial cells ⬆️ to try clear the deposits
Lupus, IgA, C3G x.com
1. GBM stays intact
2. Mesangium acts as sieve
3. Ig, complement, with affinity for mesangial matrix
4. Low grade injury, can be progressive
5. Leukocytes cannot penetrate mesangium. So mesangial cells ⬆️ to try clear the deposits
Lupus, IgA, C3G x.com
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