Non-Streptococcal Acute Glomerulonephritis

by Carlo Raj, MD

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    00:01 Now, stop there, and now, let’s move on to non-streptoccocal acute glomerulonephritis.

    00:07 Non-streptoccocal. Maybe result of non-streptoccocal infection such as staph endocarditis, pneumococcal, meningococcemia, hepatitis B and C, mumps, HIV, varicella.

    00:19 You have a lot of viruses that are included here.

    00:22 EBV and perhaps even parasitic.

    00:24 So there are many other causes of glomerulonephritis that would be rather infectious but it could be non-streptoccocal.

    00:30 In this picture, what I'm showing you is the following.

    00:34 What you are going to be paying attention to is the following order of optomicroscopic changes.

    00:41 The first thing that always gonna do with optomicroscopy as for you to then identify the paved road.

    00:49 The smooth paved road is always going to be your basement membrane.

    00:53 Your next step is then to measure or to identify the feet or the foot processes.

    01:01 So what you will be finding when you find your foot processes, is what cell? Good. Take a look at visceral epithelial cell which is highlighted here.

    01:10 When you find such a deposit which is dark density, which you see in optomicroscopies here, those dark densities that are underneath the visceral epithelial cell then what represent what kind of deposit? Sub-epithelial.

    01:25 Next, normal basement membrane has a light gray appearance that’s the smooth paved road that we’ve been referring to, and then what we’ll do next is, well, take a look at the immunofluorescence.

    01:37 The immunofluorescence upon such a deposit of immune-complexes gives you granular pattern.

    01:43 Well, I can distinguish this from something that’s linear.

    01:46 First and foremost, take a look at the history and then repeat, repeat, repeat the number of images.

    01:51 The one that you wanna compare this to would be your linear.

    01:54 This is not linear, this is granular.

    01:58 What does granular mean to you? Oh, there’s immune-complex deposition, it just happened to be that the immune-complex deposition here for PSGN was? Sub-epithelial. Good.

    02:10 Granular, at some point it could also mean sub-endothelial.

    02:13 And if there’s a different history, well, then it would be a different diagnosis.

    About the Lecture

    The lecture Non-Streptococcal Acute Glomerulonephritis by Carlo Raj, MD is from the course Glomerulonephritis.

    Included Quiz Questions

    1. Rapidly progressive glomerulonephritis
    2. Acute tubular necrosis
    3. Acute interstitial nephritis
    4. Rheumatic fever
    5. Acute renal failure
    1. Hematuria presents 1-3 days following a strep infection.
    2. Treatment of streptococcal infection is often curative.
    3. The strain responsible for causing glomerulonephritis will never cause acute rheumatic fever.
    4. Hypertension is often transient.
    5. More than 95% of children recover completely.

    Author of lecture Non-Streptococcal Acute Glomerulonephritis

     Carlo Raj, MD

    Carlo Raj, MD

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