Saturday, August 18, 2012

CLINICAL CASE 60 Answers and Summary


WHICH OF THE FOLLOWING DISEASES IS NOT ASSOCIATED WITH A DYSREGULATION OF THE ALTERNATIVE PATHWAY OF COMPLEMENT?

Dense Deposit Disease 9%
C3 Glomerulonephritis 2%
Atypical HUS 4%
Minimal Change Disease 73%
Chronic FSGS 9%

Dysregulation of the alternative complement pathway can either result in a proliferative glomerular process or a thrombotic microangiopathy.  The 2 proliferative processes are C3 glomerulonephritis and dense deposit disease. The thrombotic microangiopathies can be from acute in terms of atypical HUS or chronic from FSGS. A chronic state of FSGS can lead to a vascular insult and cause chronic alteration of the atypical pathway. A recent case was described where FSGS occurred in association with CFH and C3 polymorphisms and dysregulation of complement pathway. MCD is usually not been associated with this; at least thus far.



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