Definition Nephritic Nephrosis nephrotic criteria with at least one nephritic criteria Simple nephrosis nephrotic criteria without nephritic criteria
Definition • Nephritic Nephrosis: nephrotic criteria with at least one nephritic criteria • Simple nephrosis: nephrotic criteria without nephritic criteria
Etiology Congenital Ns: rare Idiopathic Ns: majority Secondary ns: many causes especially in y or >13y patients causes-DIAMOND
Etiology • Congenital NS: rare • Idiopathic NS: majority • Secondary NS: many causes especially in <3y or >13y patients causes―DIAMOND
Secondary ns: DIAMOND e Infection: APSGN, HBV, HIV, shunt nephropathy, reflux nephropathy, leprosy, syphilis, schistosomiasis, hydatid disease Drug,Toxic, Allegy mercury, snake venom, vaccine pellicillamine, Heroin, gold, NSAID, captopril, probenecid, volatile hydrocarbons Neoplasma: Hodgkin' s disease, carcinoma renal cell, lung neuroblastoma, breast, and etc) Autoimmune or collagen-vascular diseases SLE. Hashimoto's thyroiditis EMc. HSP Vasculitis Genetic Disease Alport syn. Fabry syn, Nail-patella syn Sickle cell disease, Amyloidosis, Congenital nephropathy Metabolic disease. Diabetes mellitus Others Chronic transplant rejection. congenital nephroscler
Secondary NS : DIAMOND • Infection: APSGN, HBV, HIV,shunt nephropathy, reflux nephropathy, leprosy, syphilis,schistosomiasis, hydatid disease • Drug,Toxic,Allegy: mercury, snake venom, vaccine, pellicillamine, Heroin,gold, NSAID, captopril, probenecid, volatile hydrocarbons • Neoplasma: Hodgkin’s disease, carcinoma ( renal cell, lung, neuroblastoma, breast, and etc) • Autoimmune or collagen-vascular diseases: SLE, Hashimoto’sthyroiditis, EMC, HSP, Vasculitis • Genetic Disease: Alport syn., Fabry syn., Nail-patella syn., Sickle cell disease, Amyloidosis, Congenital nephropathy • Metabolic disease: Diabetes mellitus • Others: Chronic transplantrejection, congenital nephrosclerosis
Pathology Primary NS: Minimal change Nephropathy (MCN):80% Mesangial proliferative glomerulonephritis MsPGn: 10-129 Focal segmental glomerulosclerosis(FSGS): 5% Others. Membranous Nephropathy(Mn)most common in adults Membrane proliferative glomerulonephritis MPGN): 2-5% Cresent glomerulonephritis: rare, Crescent glomeruli>50% Secondary Ns: dependent on causes, APSGN, MN FSGS MsPgN or MPgn
Pathology • Primary NS: – Minimal Change Nephropathy (MCN): 80% – Mesangial proliferative glomerulonephritis (MsPGN): 10-12% – Focal segmental glomerulosclerosis (FSGS): 5% – Others: Membranous Nephropathy (MN) ―most common in adults Membrane proliferative glomerulonephritis (MPGN): 2-5% Cresent glomerulonephritis: rare, Crescent glomeruli > 50% • Secondary NS: dependent on causes, APSGN, MN, FSGS, MsPGN or MPGN
Minimal Change Nephropathy ( MCN Little or no microscopic abnormality Absence of immune complexes Effacement of epithelial foot process Occasionally mesangial hypercellurity
Minimal Change Nephropathy (MCN ) • Little or no microscopic abnormality • Absence of immune complexes • Effacement of epithelial foot process • Occasionally mesangial hypercellurity