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Chronic GN

This is characterized by persistent urinary abnormalities, slow progressive impairment renal function, symmetrically contracted kidneys, moderate to heavy proteinuria, abnormal urinary sediment (especially RBC casts)

 

The time to progression to ESRD is variable, hastened by uncontrolled hypertension and infections.

 

Drug – Induced Glomerular Disease
 

Morphologic Lesion Causative Agent
1. Minimal change diseases (usually with interstitial nephritis)  i. NSAID
ii. Recombinant interferon α
iii.  Rifampin
iv.  Ampicillin
2. Membranous nephropathy i.  Penicillamine
ii.  Gold
iii. Mercury
iv. Trimethadione
v.  Captopril
vi Clomethiazole
3.  Focal segmental glomerulosclerosis i. Heroin
4.  Pauci – immune necrotizing GN i. Ciprofloxacin
ii. Hydralazine
5. Proliferative GN with vasculitis i. Allopurinol
ii. Penicillin
iii. Sulfonamides
iv. Thiazides
v. Intravenous amphetamines
6.  RPGN i. Rifampin
ii. Warfarin
iii. Carbimazole
iv. Amoxicillin
v. Penicillamine


Glomerular Lesion Associated with Infections Diseases

 
 
Glomerular Lesion Associated with Infections Diseases  
Morphologic Lesion Common Disease or Inciting Organism
1. Diffuse proliferative glomerulo    –       
nephritis (classic postinfectious glomerulonephritis)
Streptococcal pharyngitis
 
Acute/subacute bacterial endocarditis
 
Visceral sepsis
 
Typhoid fever
 
Syphilis
 
Leptospirosis (Mycobacterium leprae)
 
Toxoplasmosis
 
Falciparum malaria
 
Plasmodium falciparum
 
Varicella, mumps, echovirus, Coxsackie virus,
 
measles
 
Infectious mononucleosis
 
Hepatitis B and C
2. Membranoproliferative glomerulonephritis Subacute bacterial endocarditis
 
Ventriculoatrial shunt infection
 
Visceral sepsis
 
Hepatitis C infection
 
Hepatitis B infection
 
P. falciparum
 
Schistosomiasis
3. Mesangial proliferative Recovery phase of postinfectious
 
glomerulonephritis
 
glomerulonephritis 
4. Membranous nephropathy Hepatitis C infection
 
Hepatitis B infection
 
Syphilis
 
Filariasis
 
Hydatid disease
 
Schistosomiasis
 
Plasmodium malariae
 
Leprosy
 
Enterococcal endocarditis
5. Focal segmental glomerulosclerosis HIV infection
 
Schistosomiasis
6. Renal amyloidosis Any chronic infection




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