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Differential diagnosis of nephrotic syndrome in the US:
- Idiopathic causes
- Minimal change disease - most common cause in children, the cause in 10-15% of adults, though more common in those with autoimmune disease
- Focal segmental glomerulosclerosis - most common in African-Americans
- Membranous nephropathy - most common in Caucasians
- Secondary causes
- Diabetes - most common cause of nephrotic syndrome in the United States
- SLE - can cause MPGN
- Collagen diseases
- Infection-related causes - HIV, HBV, HCV, malaria
- Medications - NSAIDS most common
- Amyloidosis/dysproteinemias
- Thrombotic microangiopathies
Posted 06/30/16 09:15:26 AM by Anna Krigel
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Check for compliments!! Only four causes of nephrotic syndrome that result in hypocomplimentemia:
- Cryoglobulinemia
- SLE
- Post-infectious
- Idiopathic (C3 nephropathy)
Posted 06/30/16 09:17:53 AM by Anna Krigel
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Classic signs and symptoms of nephrotic syndrome:
- Proteinuria
- Hypoalbuminemia
- Edema
- Hyperlipidemia
Posted 06/30/16 09:23:39 AM by Anna Krigel
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Amyloidosis - accounts for 4-17% of cases of seemingly idiopathic nephrotic syndrome
- Two major types
- AL or primary amyloid - monoclonal light chains form the amyloid fibrils
- AA or secondary amyloid - acute phase reactant serum amyloid A forms the amyloid fibrils
- associated with chronic inflammatory diseases such as RA/juvenile RA, spondyloarthropathies/psoriasis, IBD, FMF, or idiopathic causes
- Detected on biopsy using congo red dye for staining - will see apple-green birefringence
Posted 06/30/16 10:33:36 AM by Anna Krigel
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For further reading...
Posted 06/30/16 10:57:42 AM by Anna Krigel
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