Immune Complex-Associated Glomerulonephritis

Physiology

  • Deposition of immune complexes with complement in the glomerulus

Pathology

  • Pathology with Diffuse Alveolar Hemorrhage: pulmonary capillaritis

Diagnosis

  • PFT’s: increased DLCO during DAH
  • FOB
    • BAL: RBC’s/ hemosiderin-laden macrophages
  • OLB: may be necessary
    • Absence of immune complex deposits
  • CXR/Chest CT patterns: diffuse or patchy focal alveolar infiltrates
    • Interstitial infiltrates appear with chronic or recurrent DAH
  • Serology
    • ANA:
    • Anti-DNA:
    • RF:
    • C3/C4/CH50:
    • ANCA: negative
    • Anti-GBM: negative
  • ESR:
  • CBC:
  • Urinalysis: abnormal
  • Renal Bx: focal segmental necrotizing GLN/ crescents
    • Tissue Ab staining: granular deposition of Ig and complement in glomerulus

Clinical Presentations

Pulmonary Manifestations

  • Diffuse Alveolar Hemorrhage (see [[Diffuse Alveolar Hemorrhage]]): rare
    • Symptoms usually present for only days-weeks before presentation
    • Cough
    • Dyspnea
    • Hemoptysis: may be absent on initial presentation, even after significant alveolar hemorrhage
    • Chest pain: may occur

Renal Manifestations

  • Glomerulonephritis

Treatment

  • xxx

References

  • xxx