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Thursday, March 24, 2011

FOCAL AND SEGMENTAL GLOMERULONEPHRITIS

This condition is characterised by proliferative and sometimes necrotic changes which occurs in segments of some but not all glomeruli.
'Focal' is used to indicate that only some glomeruli are affected and 'segmental' indicates that only a segment of the glomerulus is involved.
Aetiology
It is frequently associated with systemic disease such as Henoch Schonlein purpura, microscopic poly arteritis, Wegener's granulomatosis and bacterial endocarditis. The aetiology in cases not associated with systemic disease such as systemic lupus erythmatosus.
Clinical features
The most common presenting feature is haematuria or acute glomerulonephritis syndrome. It occurs most commonly in young adults and commonly there is hypertension and impairment if renal function. Complement studies are usually normal unless there is an associated systemic disease such as systemic lupus erythmatosus.
Management
There is no specific treatment. A search should be made for underlying systemic disease which might be amenable to therapy.
Prognosis
The prognosis is generally good and only a small minority progress to renal impairment. In patients with an underlying systemic disease this determines the outlook.

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