Diffuse Proliferative GN

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edwinchowyw

Renal pathology tutorial for nephrologists

Health & Medicine Technology

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INTRODUCTION Myeloma cells majorly discharge antibodies known as paraprotein (Durie et al., 1975). To make a diagnosis of myeloma, physicains will observe for this paraprotein in the blood or urine(Fisher,1938) .Once the patient have been diagnosed with myeloma, physicians will regularly assess the paraprotein levels to monitor the disease (Fudenberg et al., 1971). Disorders characterised by the production of a paraprotein majorly include monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma and Waldenströms Macroglobulinaemia (Grabar et al., 1953). Paraproteins may also be a feature of CLL (Chronic lymphocytic leukemia), or amyloidosis. MGUS is a diagnosis of exclusion: 4% of over the age of 72 and 5% of over the age of 85 have a paraprotein which is frequently found incidentally and not allied with symptoms or physical findings (Hills, 1966).

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Rapidly progressive glomerulonephritis (RPGN) is a syndrome of the kidney that is characterized by a rapid loss of renal function,[4][5] (usually a 50% decline in the glomerular filtration rate (GFR) within 3 months)[5] with glomerular crescent formation seen in at least 50%[5] or 75%[4] of glomeruli seen on kidney biopsies. If left untreated, it rapidly progresses into acute renal failure[6] and death within months. In 50% of cases, RPGN is associated with an underlying disease such as Goodpasture syndrome, systemic lupus erythematosus or granulomatosis with polyangiitis; the remaining cases are idiopathic. Regardless of the underlying cause, RPGN involves severe injury to the kidneys' glomeruli, with many of the glomeruli containing characteristic glomerular crescents (crescent-shaped scars)

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