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Acute Nephritis - Coggle Diagram

- - - - features
        
        skin rash
        
        most obvious feature
        
        symm over buttocks, extensor surfaces of arms + legs, ankles
        
        spares trunk
        
        initally may be urticarial, rapidly becomes maculopapular + purpuric
        
        palpable
        
        may recur over several wks
        
        1st feature in 50%
        
        arthralgia
        
        in 2/3
        
        esp knees + ankles
        
        long term joint damage doesn't occur
        
        usually resolves before rash goes
        
        periarticular oedema
        
        abdo pain
        
        colicky
        
        if severe give corticosteroids
        
        GI petechiae can cause haematemesis + melaena
        
        intussusception can occur
        
        glomerulonephritis
        
        fever
      - peak = 3-10 y/o
      - twice as common in boys
      - peaks in winter
      - often preceded by URTI
      - cause unknown
        
        hypothesis: genetic predisposition + antigen exposure increases IgA + disrupts IgG, they interact + the complexes activate complement + vasculitis
      - clinical dx
      - comps
        
        rare
        
        ileus
        
        protein losing enteropathy
        
        orchitis
        
        CNS involvement
      - renal involvement
        
        common but rarely 1st sx
        
        over 80% have macroscopic haematuria or mild proteinuria
        
        usually complete recovery
        
        if severe proteinuria nephrotic syndrome may result
        
        risk factors for progressive renal disease
        
        heavy proteinuria
        
        oedema
        
        HTN
        
        deteriorating renal function
        
        if present do renal bx to determine need for tx
        
        all with renal involvement followed for 1 yr to detect persisting urinary abnormalities, which will be in 5-10% + require long term follow up
        
        HTN + declining renal function may develop after several yrs
    - - mainly presents in adolescent girls + young women
      - commoner in Asians + Afrocaribbeans
      - multiple autoabs e.g. anti-dsDNA
      - C3+4 complement components may be low
      - do renal bx if proteinuria or haematuria
        
        immunosuppression will always be needed in this situation + dose depends on bx results
    - - prominent involvement of resp tract
      - ANCA +ve
    - - do renal arteriography to look for aneurysms
- - - - mother may have haematuria