-IBIS-1.5.0-
tx
urinary system
glomerulonephritis
diagnoses

definition and etiology

definition:
A disease characterized pathologically by diffuse inflammatory changes in the glomeruli and clinically by the abrupt onset of proteinuria, hematuria, and usually RBC casts.

etiology:
The classic example is post-streptococcal glomerulonephritis (PSGN). This is a complex and theoretical autoimmune condition wherein antigen-antibody complexes from a streptococcal infection in another area of the body are deposited in the glomeruli. This stimulates a breakdown of the walls of the glomeruli.
Other post-infectious glomerulonephritis conditions occur following such diseases as hepatitis, syphilis, and malaria. These specific examples may lead to sclerosing and excessive proteinuria which is called "nephrotic syndrome".

signs and symptoms

signs and symptoms:
• edema
• oliguria
• bloody urine
• hypervolemia
• headaches
• visual disturbances due to hypertension.

The physician should be sure to question whether the patient had a sore throat or some infection some time prior to these symptoms.
Patients who are treated with cortisone rather than antibiotics have experienced disastrous results.
Urinary changes resulting from blood, and debris being sloughed off are the primary changes seen.

lab findings:
• (+) ASO titer
• hematuria, casts (esp. red cell casts), fat deposits in urine
• azotemia
• increased ESR
• leukocytosis
• mild anemia

course and prognosis

Prognosis is good if diagnosed and treated early. Increased proteinuria and nephrotic syndrome carry a worse prognosis.

differential diagnosis

• bladder infection
• urethritis
• renal vein thrombosis
• bacterial endocarditis
• cardiac or hepatic failure


footnotes