Wednesday, August 12, 2015

How the Differential Diagnosis of Nephrotic Syndrome

1. nephritis patients have rashes, purpura, joint pain, characterized by abdominal pain and blood in the stool, there are characteristics of nephritis hematuria, proteinuria, edema, hypertension and so on. If purpura characterized by atypical misdiagnosed as primary nephrotic syndrome. Early this disease is often associated with elevated serum IgA. Diffuse mesangial proliferative renal biopsy is a common pathology, immunology and pathology is IgA C3 as the main sediment, it is not difficult to identify.

2. lupus nephritis more common in women 20 to 40 years, many patients have fever, rash and joint pain, antinuclear antibody, anti-ds-DNA, anti-SM antibodies, complement C3 decreased renal biopsy light microscopy in addition to mesangial hyperplasia, the lesions characteristic diversity. Immunopathology was "full house."

3. Diabetic nephropathy patients prone to diabetes for more than 10 years, can be expressed as nephrotic syndrome. Fundus examination microvascular change. Renal biopsy shows glomerular basement membrane thickening and mesangial matrix, typical damage to Kimmelstiel-Wilson nodules. Renal biopsy can confirm the diagnosis.

4.The hepatitis B virus associated nephritis nephrotic syndrome virus confirmed viremic serum, kidneys Free pathological examination revealed the hepatitis B virus antigen component.


5.Wegner nose and granulomatous inflammation, pneumonia, three characteristics of necrotizing glomerular sinus based disease necrotizing. Clinical features of renal damage is rapidly progressive glomerulonephritis or nephrotic syndrome. Serum γ-globulin, IgG, IgA increased.

6. amyloid early diabetic nephropathy can only proteinuria, usually after 3 to 5 years nephrotic syndrome, serum γ-globulin, heart, liver, splenomegaly, skin serum γ-globulin lichen-like myxoid edema, diagnosed rely on biopsy.

7. nephrotic syndrome caused by malignant tumors can cause a variety of malignant tumors by immune mechanisms nephrotic syndrome, nephrotic syndrome and even early clinical manifestations. Therefore, nephrotic syndrome patients should do a comprehensive examination to exclude malignancy.

8. graft after renal transplantation relapse after kidney allograft nephropathy syndrome relapse rate of about 10%, usually after 1 week to 25 months, proteinuria, recipients often severe nephrotic syndrome and six months to 10 years, the loss of the transplanted kidney.

9. A drug-induced nephrotic syndrome organic gold, mercury, D- penicillamine, captopril (captopril), non-steroidal anti-inflammatory drugs have cause nephrotic syndrome (such as membranous nephropathy) reported. It should be noted medication history, timely withdrawal may cause remission.


If you have any questions you want advice, you can contact us by email: chinakidneyhospital@gmail.com or Tel: +8613633219293.

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