The pathogenesis of acute proliferative glomerulonephritis -
Ans. is 'b' i.e., Immune complex mediated o Postinfectious acute proliferative glomerulonephritis is due to immune-complex mediated (Type III) hypersensitivity.Rapidly progressive glomerulonephritiso Rapidly progressive glomerulonephritis (RPGN) is a syndrome associated with severe glomerular injury and does not denote a specific etiology form of glomerulonephritis,o RPGN is defined by 2 criteria.Presence of epithelial crescentsOccurrence of rapidly progressive renal failure.o In most cases, the glomerular injury is immunologically mediated,o RPGN is divided into three groupsType I (Anti-GBM antibody)Characterized by the presence of autantibodies directed against the glomerular basement membrane (GBM).It is also called anti-GBM glomerulonephritis.The antibodies are directed against a particular protein found in GBM, type IV collegen, specifically the noncollagenous region of its a3 chain.Type II (Immune complex)Caused by deposition of immune complex.Thus immune complex disease causes type II RPGN.Type III (Pauci-immune)Most common type of RPGN.Defined by the lack of anti-GBM antibodies or immune complex.Instead, the glomeruli are damaged in an undefined manner, perhaps through activation of neutrophils in response to anti-neutrophilic cytoplasmic antibodies (ANCA).RAPIDLY PROGRESSIVE GLOMERULONEPHRITISTypeIRPGN(anti GBM antibody)o Idiopathico Goodpasture syndromeTypelIRPGN(Immune complex)o Idiopathico Post infectiouso Systemic lupus erythematouso Henoch schonlein purpurao IgA nephropathyo Membranoproliferative GNo CryoglobulinaemiaType III RPGN(Pauci immune)o ANCA associatedo Idiopathico Wegener granulomatosiso Microscopic PANo Microscopic polyangitis Note - Post infectious glomerulonephritis may be post streptococcal or post infective endocarditis.
Cytotoxic T-cell mediated
Immune complex mediated
Antibody mediated
Cell-mediated (Typer IV)
Glomerular Diseases