robin082006
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333. A 35-year-old female recovering from hepatitis B develops hematuria, proteinuria, and red cell casts in the urine. Which of the following would best describe the changes within the kidney in this patient?
a. Plasma cell interstitial nephritis
b. IgG linear fluorescence along the glomerular basement membrane
c. Granular deposits of antibodies in the glomerular basement membrane
d. Diffuse thickening of the glomerular basement membrane by subepithelial immune deposits
e. Nodular hyaline glomerulosclerosis
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| yasmeen
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I THINK ITS D. ANY OTHER WISE IDEAS?
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| vallia
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I think is C
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| lalitha
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IS IT C
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| skyhigh
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membranous glomerulonephritis, D
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| robin082006
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C is the answer
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| skyhigh
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i guess membranous glomerulophritis would show wire loop pattern with subendothelial deposits, but for SLE. In general it would be subepithelial deposits.
I don't get choice C, Can someone explain please.
Edited by skyhigh on 03/22/06 - 07:56 AM
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| vallia
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I was thinking that is a nephritic syndrome ( because of red cell casts in urine). the disorder it's a postinfectious proliferative glomerulonephritis ( same like poststreptococal glomeruloneprhitis).It is an immune complex disease with characteristic granular deposits of IgG or C3 ("lumpy bumpy " granular pattern)
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| drbin
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sure it is a nephritic syndrome bs of hematuria but i thought it is membrano proliferative GN bs it is more common after HBV/HCV infection. so i thought the answer was D. but if the answer is C Vallia's expln is good bs of red cell casts it must be a/c proliferative GN which shows granular subepithelial humps.
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| robin082006
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[left](Cotran, pp 943–948.) Glomerular injury caused[/left] [left]by circulating antigen-antibody complexes is a secondary effect from a[/left] [left]nonrenal primary source. Numerous clinical examples exist of a serum[/left] [left]sickness–like nephritis as a consequence of systemic infection, with classic[/left] [left]clinical models such as syphilis, hepatitis B, malaria, and bacterial endocarditis[/left] [left]leading to renal disease. Immune complexes to antigens from any[/left] [left]of these sources are circulating within the vascular system and become[/left] [left]entrapped within the filtration system of the glomerular basement membranes.[/left] [left]This can be seen as granular, bumpy deposits by immunofluorescence[/left] [left]within the basement membranes of the glomeruli.[/left]
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