Clinical Trials in Pauci-Immune GN, Pauci-Immune Glomerulonephritis (GN), Glomerulonephritis: Causes скачать в хорошем качестве

Clinical Trials in Pauci-Immune GN, Pauci-Immune Glomerulonephritis (GN), Glomerulonephritis: Causes

A 28-year-old man with antiphospholipid antibody syndrome and relapsing polychondritis presents after two weeks of malaise, sinus congestion, chest pain on deep inspiration, and dark urine. Laboratory studies reveal hematuria with dysmorphic red cells, proteinuria, reduced kidney function, and a high-titer ANCA positivity for MPO. What clinical signs and laboratory findings should help narrow your differential in this complex glomerulonephritis case? VIDEO INFO Category: Clinical Trials in Pauci-Immune GN, Pauci-Immune Glomerulonephritis (GN), Glomerulonephritis: Causes, Diagnosis, and Management, Nephrology: Kidney Disease Diagnosis and Management Difficulty: Easy - Basic level - Suitable for medical students Question Type: Diagnosis - Identify conditions based on clinical presentation Case Type: Common Scenario Explore more ways to learn on this and other topics by going to https://endlessmedical.academy/auth?h... QUESTION A 28-year-old man reports 2 weeks of feeling unwell with stuffy sinuses, chest pain with deep breaths, and dark, cola-colored urine. He has antiphospholipid antibody syndrome and relapsing polychondritis diagnosed in adolescence, a remote Clostridioides difficile infection, and prior cytomegalovirus infection. He denies joint swelling and has no known silica exposure. Medications are warfarin 5 mg daily for antiphospholipid syndrome and loratadine 10 mg daily for allergies.... OPTIONS A. Kidney inflammation from immune antibodies (ANCA-associated vasculitis) affecting both kidneys and lungs, causing a pauci-immune crescentic glomerulonephritis with pulmonary-renal features. B. Anti-GBM disease with lung and kidney bleeding even though the anti-GBM blood test is negative in this case. C. IgA kidney disease after a sore throat with urine blood at the same time and with a normal chest image. D. Kidney injury from uric acid crystals with severe flank pain and a urine test that does not show misshapen red cells or casts. CORRECT ANSWER A. Kidney inflammation from immune antibodies (ANCA-associated vasculitis) affecting both kidneys and lungs, causing a pauci-immune crescentic glomerulonephritis with pulmonary-renal features. EXPLANATION The most likely diagnosis is ANCA-associated vasculitis with pulmonary-renal involvement, producing pauci-immune crescentic glomerulonephritis and alveolar hemorrhage. The basics: MPO-ANCA positivity, dysmorphic red blood cells with numerous RBC casts, and new bilateral patchy opacities with hypoxemia point to small-vessel vasculitis affecting glomerular and alveolar capillaries. Normal complement and negative anti-GBM serology further support AAV over immune-complex or anti-GBM disease. The estimated GFR around 45.8 mL/min/1.73 m2 indicates significant but not end-stage kidney dysfunction, consistent with active GN. Anti-GBM disease with lung and kidney bleeding even though the anti-GBM blood test is negative is less likely here because anti-GBM serology is negative and MPO-ANCA is strongly positive; while rare seronegative cases exist, the total pattern fits AAV better. IgA kidney disease after a sore throat with a normal chest image conflicts with this patient s chest radiograph showing bilateral opacities and with RBC casts typical of active crescentic GN; IgA disease does not typically cause diffuse alveolar hemorrhage.... Further reading: Links to sources are provided for optional further reading only. The questions and explanations are independently authored and do not reproduce or adapt any specific third-party text or content. --------------------------------------------------- Our cases and questions come from the https://EndlessMedical.Academy quiz engine - multi-model platform. Each question and explanation is forged by consensus between multiple top AI models (i.e. Open AI GPT, Claude, Grok, etc.), with automated web searches for the latest research and verified references. Calculations (e.g. eGFR, dosages) are checked via code execution to eliminate errors, and all references are reviewed by several AIs to minimize hallucinations. Important note: This material is entirely AI-generated and has not been verified by human experts; despite stringent consensus checks, perfect accuracy cannot be guaranteed. Exercise caution - always corroborate the content with trusted references or qualified professionals, and never apply information from this content to patient care or clinical decisions without independent verification. Clinicians already rely on AI and online tools - myself included - so treat this content as an additional focused aid, not a replacement for proper medical education. Visit https://endlessmedical.academy for more AI-supported resources and cases. This material can not be treated as medical advice. May contain errors. ---------------------------------------------------