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→Autopsy Findings
== Clinical Summary ==
This 1727-year-old white male had end-stage renal disease requiring hemodialysis for 10 years. For the previous four years he had hypertension which slowly increased to about 180/120 mm Hg. Laboratory findings included a greatly markedly elevated BUN and creatinine. He was admitted for underwent bilateral nephrectomy and discharged in satisfactory condition was placed on the 10th postoperative day. He was to be contacted in the future for transplantationtransplant list.
== Images ==
File:IPLab6GN10.jpg|For comparison this is an immunofluorescent photomicrograph of a glomerulus from a patient with Goodpasture's syndrome. The linear (arrows) immunofluorescence is characteristic of Goodpasture's syndrome.
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== Virtual Microscopy ==
<peir-vm>IPLab6GN</peir-vm>
== Study Questions ==
* <spoiler text="What is the usual clinical course of poststreptococcal glomerulonephritis?">One to two weeks after infection (usually sore throat or skin infection) by certain types of group A beta-hemolytic streptococci, patients develop malaise, fever, nausea, oliguria, and hematuria. Most patients recover with conservative treatment aimed at maintaining sodium and water balance. The renal injury usually resolves with no loss of function.</spoiler>
* <spoiler text="What is the pathogenetic mechanism of poststreptococcal glomerulonephritis?">Patients have elevated antibody titers to streptococcal antigens, decreased complement levels, and accumulations of immune complexes and complement in the glomeruli suggesting immune complex mediated glomerular injury. Some streptococcal antigens (endostreptosin and several cationic antigens) have been demonstrated on the glomerular basement membrane. Thus, it is not known for sure if the glomerular damage is caused by circulating antigen antibody complexes, antibodies attacking streptococcal antigens that are attached to the basement membrane, or a combination of both processes. In any event, antibodies bind to antigens, activate complement, and cause damage to the glomeruli.
</spoiler>
== Additional Resources ==
=== Reference ===
* [http://emedicine.medscape.com/article/429314-overview eMedicine Medical Library: Assessment and Management of the Renal Transplant Patient]
* [http://emedicine.medscape.com/article/240337-overview eMedicine Medical Library: Poststreptococcal Glomerulonephritis]
* [http://www.merckmanuals.com/professional/genitourinary_disorders/glomerular_disorders/nephritic_syndrome.html Merck Manual: Nephritic Syndrome]
* [http://www.merckmanuals.com/professional/genitourinary_disorders/chronic_kidney_disease/chronic_kidney_disease.html Merck Manual: Chronic Kidney Disease]
* [http://www.merckmanuals.com/professional/genitourinary_disorders/renal_replacement_therapy/hemodialysis.html Merck Manual: Hemodialysis]
* [http://www.merckmanuals.com/professional/immunology_allergic_disorders/transplantation/kidney_transplantation.html Merck Manual: Kidney Transplantation]
=== Journal Articles ===
* Lan HY, Yang N, Nikolic-Paterson DJ, Yu XQ, Mu W, Isbel NM, Metz CN, Bucala R, Atkins RC. [http://www.ncbi.nlm.nih.gov/pubmed/10652026 Expression of macrophage migration inhibitory factor in human glomerulonephritis]. ''Kidney Int'' 2000 Feb;57(2):499-509.
=== Images ===
* [{{SERVER}}/library/index.php?/tags/226-glomerulonephritis PEIR Digital Library: Glomerulonephritis Images]
* [http://library.med.utah.edu/WebPath/RENAHTML/RENALIDX.html#8 WebPath: Glomerulonephritis]
== Related IPLab Cases ==
* [[IPLab:Lab 1:Kidney Infarction|Lab 1: Kidney: Infarction (Coagulative Necrosis)]]
{{IPLab 6}}
[[Category: IPLab:Lab 6]]