Glomerulonephritis: Difference between revisions
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==Background== | ==Background== | ||
*Characterized by hematuria and proteinuria | *Characterized by [[hematuria]] and [[proteinuria]] | ||
== | ===Causes=== | ||
*Poststreptococcal glomerulonephritis | |||
*Hemolytic-uremic syndrome | |||
*Henoch-Schonlein purpura | |||
*IgA nephropathy | |||
*Lupus | |||
*Alport syndrome | |||
==Clincal 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 a/w HTN | *Often a/w HTN | ||
*[[Hematuria]], [[proteinuria]], RBC casts | |||
== | ==Differential Diagnosis== | ||
{{Hematuria DDX}} | |||
==Work-Up== | ==Diagnosis== | ||
===Work-Up=== | |||
*UA | *UA | ||
*CBC | *CBC | ||
*Chemistry | *Chemistry | ||
Revision as of 21:56, 25 March 2015
Background
- Characterized by hematuria and proteinuria
Causes
- Poststreptococcal glomerulonephritis
- Hemolytic-uremic syndrome
- Henoch-Schonlein purpura
- IgA nephropathy
- Lupus
- Alport syndrome
Clincal Presentation
- History
- Often a/w HTN
- Hematuria, proteinuria, RBC casts
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
Diagnosis
Work-Up
- UA
- CBC
- Chemistry
- Albumin (often reduced in acute glomerulonephritis)
- C3, C4, ASO
Treatment
Defer to nephrologist
Disposition
Coordinate with nephrologist
Source
Tintinalli