Anatomical Pathology
Immune mediated Glomerular disease
Immune complex disease-granular deposits
Anti-BM disease
Circulating immune complex(>deposited in the glomerulus(Ag/Ab)>activate complement.>↑ in inflammatory cells
Foreign antigens deposited in BM to which Ab are attached>>complement activation
Has linear deposits due to antibodies specific against the BM
Spectrum
Post-streptococcal glomerulonephritis-antigen complex stuck underneath the endothelium>complement cascade activated>lots of cells come into glomerulus>release enzymes>damages endothelium cells>cause endothelial cell proliferation>BM damaged>Present with Hematuria
IgA nephropathy>Deposits in the mesongium
Membranous Nephropathy(Nephrotic): Antigens stuck underneath podocytes>podocytes damaged>foot processes destroyed>leakage of proteins into urinary space
SLE-Overlap
Glomerulonephritis-macro
CRF-ongoing process= fibrosis >cause fibrosis>kidney small & has granules
ARF>Large(LOTS of blood volume into kidney-not filtered), Pale(cortex-endothelial cells damaged>swell & proliferate>blockage of blood into glomeruli), edematous(↑ Hydrostatic pressure)
Micro
Tubules=Nephritic: Red cell casts, Nephrotic-protein casts
Interstitium-oedematous(
Glomeruli-changes in cellular composition & BM , Immunolabelling=IgG and/or granular deposits
Blood vessels>Hypertensive changes (late stages)