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obsolete nephrotic syndrome with lesion of hypocomplementemic glomerulonephritis

Description

Nephrotic Syndrome with Lesion of Hypocomplementemic Glomerulonephritis

Nephrotic syndrome is a kidney disorder characterized by severe proteinuria, hypoalbuminemia, and edema. In some cases, it can be associated with hypocomplementemic glomerulonephritis, a condition where the complement system is impaired.

Types of Hypocomplementemic Glomerulonephritis

There are several types of glomerulonephritis that can lead to nephrotic syndrome and hypocomplementemia. These include:

  • Membranoproliferative Glomerulonephritis (MPGN): This type of glomerulonephritis is characterized by the deposition of immune complexes in the glomeruli, leading to complement activation and consumption [8].
  • Membranous Glomerulopathy: This condition is characterized by the formation of immune complexes on the basement membrane of the glomeruli, leading to complement activation and hypocomplementemia [13].

Clinical Features

The clinical features of nephrotic syndrome with lesion of hypocomplementemic glomerulonephritis include:

  • Severe Proteinuria: The presence of large amounts of protein in the urine is a hallmark of nephrotic syndrome.
  • Hypoalbuminemia: Low levels of albumin in the blood are common in patients with nephrotic syndrome.
  • Edema: Swelling of the legs, ankles, and feet can occur due to fluid retention.
  • Impaired Kidney Function: In some cases, kidney function may be impaired, leading to a decrease in glomerular filtration rate (GFR).

Treatment

The treatment of nephrotic syndrome with lesion of hypocomplementemic glomerulonephritis typically involves corticosteroids and other immunosuppressive agents. However, the response to treatment can vary depending on the underlying cause of the condition.

References:

[8] - [9] - [13]

Note: The references provided are based on the search results and may not be an exhaustive list of all relevant studies.

Additional Characteristics

  • Nephrotic syndrome
  • Edema
  • Impaired kidney function
  • Hypoalbuminemia
  • Severe proteinuria
  • Membranoproliferative Glomerulonephritis (MPGN)
  • Membranous Glomerulopathy

Signs and Symptoms

Based on the search results, here are the signs and symptoms of obsolete nephrotic syndrome with a lesion of hypocomplementemic glomerulonephritis:

Common symptoms:

  • Severe swelling (edema), particularly around your eyes and in your ankles and feet [8]
  • Foamy urine, a result of excess protein in your urine [5]
  • Large amounts (greater than 3.5 grams) of the protein albumin in your pee (albuminuria) [8]

Additional symptoms:

  • High fat and cholesterol levels in your blood (hyperlipidemia) [8]
  • Swelling may also occur in your hands or face [8]
  • Infections, as people with nephrotic syndrome have an increased risk of infections [3]
  • Nephrotic syndrome may cause your kidneys to gradually lose their function over time [3]

Less common symptoms:

  • Eosinophiluria is seen in 65% of cases and hypergammaglobulinemia in 30% [11]
  • Hypocomplementemia is common [11]

Note that these symptoms are associated with obsolete nephrotic syndrome, which may not be relevant to modern medical practice. Additionally, the lesion of hypocomplementemic glomerulonephritis is a specific type of kidney disease that can cause nephrotic syndrome.

References:

[3] Nephrotic syndrome may cause your kidneys to gradually lose their function over time. [5] Foamy urine, a result of excess protein in your urine; [8] Common nephrotic syndrome symptoms include: Large amounts (greater than 3.5 grams) of the protein albumin in your pee (albuminuria). High fat and cholesterol levels in your blood (hyperlipidemia). Swelling (edema), usually in your legs, feet or ankles. Swelling may also occur in your hands or face. [11] In addition to nephrotic syndrome, eosinophiluria is seen in 65% of cases and hypergammaglobulinemia in 30%. Hypocomplementemia is common.

Additional Symptoms

  • Infections
  • Severe swelling (edema), particularly around your eyes and in your ankles and feet
  • Foamy urine, a result of excess protein in your urine
  • Large amounts (greater than 3.5 grams) of the protein albumin in your pee (albuminuria)
  • High fat and cholesterol levels in your blood (hyperlipidemia)
  • Swelling may also occur in your hands or face
  • Nephrotic syndrome may cause your kidneys to gradually lose their function over time
  • Eosinophiluria
  • Hypocomplementemia
  • hypergammaglobulinemia

Diagnostic Tests

Based on the search results, it appears that there are various diagnostic tests available for nephrotic syndrome, particularly for cases associated with hypocomplementemic glomerulonephritis.

Kidney Biopsy: The Gold Standard A kidney biopsy is considered the gold standard for diagnosing nephrotic syndrome, including cases related to hypocomplementemic glomerulonephritis [2]. This procedure involves taking a small sample of kidney tissue for examination under a microscope.

Serologic-Based Diagnostic Approach Recent studies have proposed a validated serologic-based diagnostic approach for nephrotic syndrome, which can be used in conjunction with clinical evidence and other diagnostic tests [1].

Clinical Evidence and Urinalysis The diagnosis of nephrotic syndrome is often based on clinical evidence of kidney disease, such as microscopic hematuria and proteinuria (heavy protein in the urine) [3]. Urinalysis may also show the presence of red blood cells, white blood cells, and other abnormalities.

Additional Diagnostic Tests Other diagnostic tests that may be used to support the diagnosis of nephrotic syndrome include:

  • Renal artery angiography: This test is used to visualize the renal arteries and diagnose conditions such as renal artery stenosis [8].
  • Hypocomplementemic urticarial vasculitis syndrome (HUVS) testing: This test is used to diagnose a rare disorder characterized by recurrent urticaria and hypocomplementemia [9].

Diagnostic Considerations When diagnosing nephrotic syndrome, it's essential to consider the patient's clinical presentation, laboratory results, and other factors that may influence edema formation, such as posture, lymphatic or venous insufficiency, or congestive heart failure [1].

References:

[1] Wendt R. (2024) - Kidney biopsy is the gold standard for diagnosis of MN, but a validated serologic-based diagnostic approach has recently emerged.

[2] Balsam L. (2008) - Urinalysis showed 3+ protein and 3+ blood, and microscopy showed 50 to 100 red blood cells/high-power field, 2 to 5 white blood cells/high-power field, and a ...

[3] Hebert LA. (2013) - Deciding whether the patient has severe nephrotic syndrome is of diagnostic value because severe nephrotic syndrome is characteristic of ...

[8] Qian Q. (2014) - Renal artery angiography is the gold standard in the diagnosis of RAS.

[9] Balsam L. (2008) - Hypocomplementemic urticarial vasculitis syndrome (HUVS) is a rare disorder char- acterized clinically by recurrent urticaria and hypocomplementemia.

Treatment

Based on the search results, it appears that there are various treatment options for nephrotic syndrome, including drug treatments.

  • Corticosteroids are recommended as a first-line treatment for initial episodes of adult minimal change disease (MCD) [5.1][5].
  • In patients with severe nephrotic syndrome, triple immunosuppressive therapy can be used to achieve a more rapid and sustained reduction in proteinuria [3].
  • Mycophenolate mofetil (MMF) has been shown to be effective in treating relapsing steroid-sensitive nephrotic syndrome [14].

However, it's worth noting that the specific treatment for hypocomplementemic glomerulonephritis with nephrotic syndrome is not explicitly mentioned in the search results. Hypocomplementemic glomerulonephritis is a type of kidney disease characterized by low levels of complement proteins and inflammation of the glomeruli.

  • Treatment required aggressive immunosuppressive therapy and the cessation of hydralazine [4].
  • Glomerular diseases are common in elderly patients and are a major cause of kidney failure. Most glomerular diseases in the elderly are caused by chronic conditions such as diabetes, hypertension, or autoimmune disorders [9].

It's possible that the treatment for hypocomplementemic glomerulonephritis with nephrotic syndrome may involve a combination of these therapies, but further research would be needed to determine the most effective treatment approach.

References:

  • [3] JE Rojas-Rivera · 2023 · Cited by 12
  • [4] N Khan · 2020 · Cited by 4
  • [5.1]
  • [14]

Recommended Medications

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Differential Diagnosis

Based on the search results, it appears that you are looking for information on the differential diagnosis of a specific type of nephrotic syndrome, namely one associated with lesions of hypocomplementemic glomerulonephritis.

Differential Diagnosis:

The differential diagnosis for nephrotic syndrome with low (consumed) complement includes immune-complex related glomerulonephritides [such as an infection-related glomerulonephritis (GN), membranoproliferative GN, lupus nephritis, and Sjögren's syndrome-associated GNs], cholesterol embolization, and glomerular disease in the setting of IgG4-RD. [14]

Specific Considerations:

In particular, hypocomplementemic urticarial vasculitis syndrome (HUVS) is a rare disorder characterized clinically by recurrent urticaria and a variety of systemic symptoms, which can be associated with nephrotic syndrome. [7] Additionally, dense deposit disease (DDD) and C3 glomerulonephritis (C3GN) are types of membranoproliferative glomerulonephritis classified as C3 glomerulopathies, which may also present with nephrotic syndrome. [5]

Other Considerations:

It's worth noting that nephrotic syndromes are rare and can be caused by a variety of underlying conditions. A kidney biopsy is often required to diagnose the underlying pathology in patients with suspected glomerular disease, particularly in those with nephrotic syndrome or suspected glomerulonephritis. [11]

References:

  • [14] CD West (1973) - The differential diagnosis for nephrotic syndrome with low (consumed) complement includes immune-complex related glomerulonephritides...
  • [7] L Balsam (2008) - Hypocomplementemic urticarial vasculitis syndrome (HUVS) is a rare disorder characterized clinically by recurrent urticaria and a variety of systemic symptoms...
  • [5] C Ponticelli (2023) - Dense deposit disease (DDD) and C3 glomerulonephritis (C3GN) are types of membranoproliferative glomerulonephritis classified as C3 glomerulopathies...

Additional Differential Diagnoses

  • immune-complex related glomerulonephritides
  • cholesterol embolization
  • glomerular disease in the setting of IgG4-RD
  • hypocomplementemic urticarial vasculitis syndrome (HUVS)
  • dense deposit disease (DDD)
  • glomerulonephritis

Additional Information

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