内科学 肾小球疾病(英文).ppt

* clinical course affects children young adults present with hematuria often after a respiratory infection All kind nephritis and nephrotic syndrom ARF10%, Only 30% of patients with IgA nephropathy has progressive disease slow progression to CRF in 15-40% of cases in 20 years * * Treatment Treatment is depended on type of nephritis and nephrotic syndrom In progressive disease, use of ACEI of fish oil may be beneficial, may be not enough. Immunosuppressive therapy in patients with Ig A nephropathy has not consistently shown to be of benefit * * Question Clinical classifications of Glomerular Diseases Pathologic classifications of Glomerular Diseases Definition of Rapidly Progressive GN What have we learned? * * Thank you for your attention! * Edema Nephrotic Edema hypoalbuminemia Nephritic Edema unbalance of glomerulus and tubules * Hypertension Renal Dysfunction Acute Chronic * Question Clinical classifications of Glomerular Diseases Pathologic classifications of Glomerular Diseases * Acute glomerulonephritis * * Etiology Following infections by nephritogenic strains of Group A ? hemolytic streptococci Pharyngitis (serotypes 1, 2, 4 and 12) Impetigo (serotypes 47,49, 57) Close contact with potentially infected individuals occurs in child care and grade school * * Pathology enlarged hypercellular glomeruli proliferation of glomerular cells infiltration by WBC’s compression of glomerular capillary lumina granular deposits of IgG, IgM C3 in the mesangium along the GBM electron dense deposits – “humps” * * * * * * * * * * Clinical Features About1- 3 weeks after a sore throat or skin infection. Haematuria :30 ~ 50% patients have Cola-or tea-colored urine ,Proteinuria: urine protein + ~ +++ . Oliguria:all most patients have variant oliguria Edema : which star at usually face, then develop to ankles ,even to trunk. * * Clinical Features Hypertention :30 ~ 70% patients occur still the end of oliguria; Renal involveme