Difference between glomerulus in FSGN and RPGN?

[NeedToStudy]

You look at the glomerulus in Focal Segmental Glomerulonephritis and the Glomerulus in Rapidly Progressive Glomerulonephritis and they both seem to look the same. Technically there should be crescent formation in RPGN and in FSGN there is sclerosis of only a certain part of the Glomerulus. So how does one differentiate the appearance between the two?

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[tpsreport]

FSGN is like a C, where the part that isn't the C is sclerosed.
RPGN is also a C, except the C is the part that is affected.

The clinical pictures are also really different. One is nephritis while the other is nephrotic syndrome. I doubt you'll get a question that is just a histology slide, and asking you to identify the subset of nephritic/nephrotic syndrome. Knowing the labs and the typical clinical presentations will help a great deal.

RPGN will most likely have a linear IF, whereas FSGN will be a heroin addict, an African American, or someone of Hispanic ethnicity presenting with 3+ proteinuria.

DPGN and MPGN types of nephritis can get severe enough to also cause nephrotic syndrome, but those again, are really different from FSGN and RPGN.

 

[NeedToStudy]

FSGN is like a C, where the part that isn't the C is sclerosed.
RPGN is also a C, except the C is the part that is affected.

The clinical pictures are also really different. One is nephritis while the other is nephrotic syndrome. I doubt you'll get a question that is just a histology slide, and asking you to identify the subset of nephritic/nephrotic syndrome. Knowing the labs and the typical clinical presentations will help a great deal.

RPGN will most likely have a linear IF, whereas FSGN will be a heroin addict, an African American, or someone of Hispanic ethnicity presenting with 3+ proteinuria.

DPGN and MPGN types of nephritis can get severe enough to also cause nephrotic syndrome, but those again, are really different from FSGN and RPGN.

Ok thanks. I already knew the clinical picture but was just worried about them giving me the picture and asking to make the diagnosis. Thanks.

 

[seminoma]

Ok thanks. I already knew the clinical picture but was just worried about them giving me the picture and asking to make the diagnosis. Thanks.

RPGN = parietal cells. FSGS = podocytes. Shouldn't look similar at all.

 

[NeedToStudy]

RPGN = parietal cells. FSGS = podocytes. Shouldn't look similar at all.

In Pathoma they have a picture of the glomerulus in both disorders and they look quite the same.

 

[solitarius]

EM is a key tool in diagnosing MCD and FSGS b/c you wouldn't be able to pick up the podocyte effacement under a typical histo-stained slide.

 

[seminoma]

In Pathoma they have a picture of the glomerulus in both disorders and they look quite the same.

You mean fig 12.8 and fig 12.14? In 12.8 you see that ring of white space surrounding the glomerulus? That's bowman's space. In fig 12.14 on the left side that space is completely gone because of all the crap in/around the parietal cells of bowman's capsule.

In 12.8 (FSGS) you can see all the mesangial sclerosis. In 12.14 (RPGN) you can see that the mesangium is relatively normal and only looks hyperplastic because the crescent is smashing the glomerulus into a smaller space.

12.8 is a higher power than 12.14, which might be contributing to why they look similar to you.