nephritic syndrome

WordNet

1. a pattern of symptoms indicative of some disease
2. a complex of concurrent things; "every word has a syndrome of meanings"
3. affected by nephritis
4. of or relating to the kidneys (同)renal

PrepTutorEJDIC

1. (疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/28 22:29:04」(JST)

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Nephritic syndrome
Classification and external resources
Specialty	urology
ICD-10	N00, N01, N03, N05
ICD-9-CM	580
MedlinePlus	000495

Not to be confused with nephrotic syndrome.

Nephritic syndrome (or acute nephritic syndrome) is a collection of signs (known as a syndrome) associated with disorders affecting the kidneys, more specifically glomerular disorders. It is characterized by having a thin glomerular basement membrane and small pores in the podocytes of the glomerulus, large enough to permit proteins (proteinuria) and red blood cells (hematuria) to pass into the urine. By contrast, nephrotic syndrome is characterized by only proteins (proteinuria) moving into the urine. Nephritic syndrome, like nephrotic syndrome, may involve hypoalbuminemia due to protein albumin moving from the blood to the urine.

Hematuria can be caused by bleeding anywhere in the urinary tract, but if the RBCs are trapped in urinary casts, it is more likely that the bleeding originated in the nephron, and nephritic syndrome becomes more probable.

It is usually distinguished from nephrotic syndrome, but sometimes the two are described as associated in a minority of cases (occasionally — and confusingly— referred to as "nephritic/nephrotic," although this is considered a progression of a nephritic syndrome and categorically not a nephrotic syndrome). Some conditions can cause either syndrome, and both syndromes can have a similar appearance upon biopsy. Neither term represents a definitive diagnosis, but both terms can be useful in the early stages of a differential diagnosis.

Signs and symptoms

Nephritic syndrome is characterized by;

• hematuria (blood in the urine), with red blood cell (RBC) casts present in the urine
• proteinuria (protein in the urine) - small amounts of protein are lost in the urine, but this is usually trivial (<3.5 g/day)
• hypertension (high blood pressure)- mild
• uremia - due to retention of waste products

and variable renal insufficiency, with;

• azotemia (elevated blood nitrogen)
• oliguria (low urine output <400 mL/day)

The main features are hypertension and RBC casts. The proteinuria in nephritic syndrome is not usually severe, but may occasionally be heavy enough to be in the range usually found in nephrotic syndrome.

Diagnosis

Nephritic syndrome is not a specific diagnosis. It is a clinical syndrome and characterized by the above signs.

An anti-streptolysin O titre (or ASOT) is typically done to test for exposure to streptococci. This test however has very poor specificity.

Differential diagnosis

The two classic diagnoses of nephritic syndrome are:

• post-streptococcal glomerulonephritis
• crescentic glomerulonephritis (also called rapidly progressive glomerulonephritis)

Nephritic syndrome causes are usually grouped into 'focal proliferative' and 'diffuse proliferative' on the basis of histology (obtained by a renal biopsy).

Focal proliferative

• IgA nephropathy
• chronic liver failure
• Celiac sprue
• dermatitis herpetiformis
• Henoch-Schoenlein purpura
• Alport syndrome
• SLE

Diffuse proliferative

• membranoproliferative glomerulonephritis (malaria, hepatitis C, chronic infection, sickle-cell disease, SLE, hemolytic uremic syndrome/thrombotic thrombocytopenic purpura)
• cryoglobulinemia
• SLE
• rapidly progressing glomerulonephritis (RPGNs) - several.

Treatment

Treatment is dependent on the underlying etiology (cause) and the degree of kidney dysfunction.

Prognosis

Because nephritic syndrome is not a disease, just a collection of symptoms, the prognosis depends on the underlying etiology.

References

External links

• Acute nephritic syndrome - medlineplus.org
• Nephritic syndrome - A to Z topics.
• Nephritic syndrome - Merck Manual.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 糸球体疾患の鑑別診断および評価 differential diagnosis and evaluation of glomerular disease
• 2. 小児における糸球体腎炎の病因と原因の概要 overview of the pathogenesis and causes of glomerulonephritis in children
• 3. 溶連菌感染後糸球体腎炎 poststreptococcal glomerulonephritis
• 4. 急速進行性（半月形）糸球体腎炎の分類および治療の概要 overview of the classification and treatment of rapidly progressive crescentic glomerulonephritis
• 5. 膜性増殖性糸球体腎炎の評価および治療 evaluation and treatment of membranoproliferative glomerulonephritis

English Journal

• Childhood-onset dense deposit disease: a rare cause of proteinuria.

• Taranta-Janusz K1, Wasilewska A, Szynaka B.
• Irish journal of medical science.Ir J Med Sci.2014 Sep;183(3):455-9. doi: 10.1007/s11845-013-1041-8. Epub 2013 Dec 14.
• INTRODUCTION: Dense deposit disease (DDD) is a rare renal disease related to the dysregulation of the alternative pathway of the complement cascade, caused by several factors including the presence of an autoantibody to C3 nephritic factor, mutations in factor H and autoantibodies to this protein. D
• PMID 24338037

• Triptolide: Progress on research in pharmacodynamics and toxicology.

• Li XJ1, Jiang ZZ2, Zhang LY3.
• Journal of ethnopharmacology.J Ethnopharmacol.2014 Aug 8;155(1):67-79. doi: 10.1016/j.jep.2014.06.006. Epub 2014 Jun 13.
• ETHNOPHARMACOLOGICAL RELEVANCE: Tripterygium wilfordii Hook. f. (Tripterygium wilfordii), also known as Huangteng and gelsemium elegan, is a traditional Chinese medicine that has been marketed in China as Tripterygium wilfordii glycoside tablets. Triptolide (TP), an active component in Tripterygium
• PMID 24933225

Japanese Journal

• ネフローゼ症候群におけるリンパ球除去療法(<特集>腎疾患とアフェレシス-最近の知見-)

• 北川 清樹,古市 賢吾,和田 隆志
• 日本アフェレシス学会雑誌 30(2), 130-134, 2011-05-31
• … A considerable permeability factor (or factors) derived from lymphocytes would have a crucial role in nephritic syndrome, especially for minimal change nephritic syndrome and focal segmental glomerulosclerosis. … We reported a series of effective cases of LCAP for nephritic syndrome. …
• NAID 110008661253

Related Links

• Acute nephritic syndrome: MedlinePlus Medical Encyclopedia

Acute nephritic syndrome is often caused by an immune response triggered by an infection or other disease. Common causes in children and adolescents include: Hemolytic uremic syndrome Henoch-Schonlein purpura

• Nephrotic vs. nephritic syndrome - Pathology Student

Here's one of those things in pathology that will lead you to pull all your hair out: what is the difference between nephrotic and nephritic syndrome? Ugh. ... It was good to point out that there are mild to modrate protinuria and edema ...

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★リンクテーブル★

リンク元	「腎炎症候群」
拡張検索	「infantile nephritic syndrome」
関連記事	「nephritic」「syndrome」

「腎炎症候群」

　　[★]

英

nephritic syndrome

同

糸球体腎炎症候群 glomerulonephritic syndrome

関

慢性腎炎症候群 chronic nephritic syndrome、急性腎炎症候群 acute nephritic syndrome

「infantile nephritic syndrome」

　　[★] 乳児ネフローゼ症候群

「nephritic」

　　[★]

• 腎炎性の、腎炎の

関

nephritis

　 　

「syndrome」

　　[★]

• n.

• 症候群