Glomerulonephritis: Difference between revisions
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*Characterized by [[hematuria]] and [[proteinuria]] | *Characterized by [[hematuria]] and [[proteinuria]] | ||
{{Glomerulonephritis causes}} | |||
== | ==Clinical Presentation== | ||
*History | *History | ||
**Recent URI or skin infection (strep) | **Recent URI or skin infection (strep) | ||
**[[Rash]], arthralgia (HSP, SLE) | **[[Rash]], [[arthralgia]] (HSP, SLE) | ||
**[[Fever]], [[vomiting]], [[diarrhea]] (HUS) | **[[Fever]], [[vomiting]], [[diarrhea]] (HUS) | ||
*Often | *Often associated with hypertension | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Hematuria DDX}} | {{Hematuria DDX}} | ||
== | ==Evaluation== | ||
===Work-Up=== | ===Work-Up=== | ||
* | *[[Urinalysis]] | ||
*CBC | *CBC | ||
*Chemistry | *Chemistry | ||
| Line 29: | Line 22: | ||
*C3, C4, ASO | *C3, C4, ASO | ||
===Diagnosis=== | |||
*[[Hematuria]], [[proteinuria]], RBC casts | |||
== | ==Management== | ||
Defer to nephrologist | *Defer to nephrologist | ||
==Disposition== | ==Disposition== | ||
Coordinate with nephrologist | *Coordinate with nephrologist | ||
== | ==References== | ||
<references/> | |||
[[Category: | [[Category:Pediatrics]] | ||
[[Category:Renal]] | |||
Latest revision as of 12:53, 14 May 2022
Background
- Characterized by hematuria and proteinuria
Causes of Glomerulonephritis
- Poststreptococcal glomerulonephritis
- Hemolytic-uremic syndrome
- Henoch-Schonlein purpura
- IgA nephropathy
- Lupus nephritis
- Alport syndrome
- Goodpasture syndrome
- Paraneoplastic
Clinical Presentation
- History
- Recent URI or skin infection (strep)
- Rash, arthralgia (HSP, SLE)
- Fever, vomiting, diarrhea (HUS)
- Often associated with hypertension
Differential Diagnosis
Hematuria
Sources of hematuria.
- Urologic (lower tract)
- Any location
- Iatrogenic/postprocedure
- GU trauma
- Infection
- Kidney stone
- Erosion or mechanical obstruction by tumor
- Ureter(s)
- Dilatation of stricture
- Bladder
- Transitional cell carcinoma
- Vascular lesions or malformations
- Chemical or radiation cystitis
- Prostate
- Benign prostatic hypertrophy
- Prostatitis
- Urethra
- Stricture
- Diverticulosis
- Foreign body
- Endometriosis (cyclic hematuria with menstrual pain)
- Any location
- Renal (upper tract)
- Glomerular
- Glomerulonephritis
- IgA nephropathy (Berger disease)
- Lupus nephritis
- Hereditary nephritis (Alport syndrome)
- Toxemia of pregnancy
- Serum sickness
- Erythema multiforme
- Nonglomerular
- Interstitial nephritis
- Pyelonephritis
- Papillary necrosis: sickle cell disease, diabetes, NSAID use
- Vascular: arteriovenous malformations, emboli, aortocaval fistula
- Malignancy
- Polycystic kidney disease
- Medullary sponge disease
- Tuberculosis
- Renal trauma
- Glomerular
- Hematologic
- Primary coagulopathy (e.g., hemophilia)
- Pharmacologic anticoagulation
- Sickle cell disease
- Myoglobinuria - positive blood, no RBCs: rhabdomyolysis
- Hemoglobinuria - positive blood, no RBCs
- Miscellaneous
- Eroding abdominal aortic aneurysm
- Malignant hypertension
- Loin pain–hematuria syndrome
- Renal vein thrombosis
- Exercise-induced hematuria
- Cantharidin (Spanish fly) poisoning
- Stings/bites by insects/reptiles having venom with anticoagulant properties
- Schistosomiasis
- Sickle Cell Trait
Evaluation
Work-Up
- Urinalysis
- CBC
- Chemistry
- Albumin (often reduced in acute glomerulonephritis)
- C3, C4, ASO
Diagnosis
- Hematuria, proteinuria, RBC casts
Management
- Defer to nephrologist
Disposition
- Coordinate with nephrologist