By Fernando C. Fervenza, James Pattison, David Goldsmith, Joseph P. Grande, Barrie Hartley
A convenient sized reference quantity for physicians in perform and coaching: prognosis, research, management;chapter order displays the 'stages' of renal ailment as noticeable in patients;one in keeping with web page or unfold of pages;superb color illustrations built-in all through - combining the benefits of an atlas with a quick text/reference.
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Additional info for Renal Medicine : a Colour Handbook
INVESTIGATIONS In AL amyloid immunoelectrophoresis and immunofixation of both serum and urine will detect a monoclonal protein in 90% of cases. A bone marrow aspiration should be done to determine whether a clonal plasma cell proliferation is present and to stain for amyloid. In the presence of renal involvement, a renal biopsy is normally performed. Ultrasound usually shows bilaterally enlarged kidneys. Less invasive sites that can be biopsied include abdominal fat pad or rectum which are both positive in 80% of patients.
The most common causes of secondary IgAN are: gastrointestinal diseases (alcoholic cirrhosis, inflammatory bowel diseases, celiac disease), rheumatoid diseases (Reiter’s, ankylosing spondylitis, psoriasis), malignancies (carcinomas, monoclonal IgA gammopathy), dermatitis herpetiformis, pulmonary hemosiderosis, mycosis fungoides, and infections IGA NEPHROPATHY 39 (HIV, hepatitis B, schistosomiasis). g. Alport’s). INVESTIGATIONS There are no specific laboratory findings for IgAN. Urinalysis shows persistent hematuria and dysmorphic red blood cells, associated with some degree of proteinuria.
It is a histologic diagnosis based on the presence of subepithelial deposits along the glomerular basement membrane. EPIDEMIOLOGY AND ETIOLOGY Membranous nephropathy is found in subjects of all ages, but it is most often diagnosed in middle-age with the peak incidence during the fourth and fifth decades of life, followed closely by the third and sixth decades. There is a 2:1 predominance of males to females diagnosed with the disease. Idiopathic membranous nephropathy affects all races. PATHOGENESIS Membranous nephropathy must be diagnosed by renal biopsy and is characterized by immune complex localization in the subepithelial zone of glomerular capillaries.