SLE nephropathy

[Anaphylactic]

1st Aid 2008 edition on pg. 430 has "sub-epithelial" deposit for SLE. Shouldn't it be "sub-endothelial?"

The latest errata from 1st Aid does not have this so I just want to 2xcheck.

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[InternationlDoc]

does both

Nephritic type is subendothelial
Nephrotic type is subepithelial

Nephritic type is more common.

ha! could already see this as a nice UWorld punk question

 

[SeventhSon]

hmmm anyone else have any more opinions, we were taught the depoists were pretty much random with SLE

 

[NegriBodies]

We were taught that they are subendothelial because of the large size of the immune complexes.

 

[mercaptovizadeh]

I believe that it can be

1.) mesangial (in type II), so it resembles diabetic nephropathy in this respect.

2.) subendothelial (in type III, IV), since it's immune complexes.

3.) subepithelial (in type V) since this manifestation is more like membranous glomerulonephritis.

For test purposes, it would usually be subendothelial, particularly since type IV is the most severe and clinically critical.

 

[osli]

SLE can do darn near anything in the kidney but anti-GBM

- Mesangial nephritis (II): deposits in mesangium with or without proliferation
- Focal proliferative nephritis (III): deposits in subendothelium or subepithelium, with focal segmental proliferation and possibly necrosis
- Diffuse proliferative nephritis (IV): deposits anywhere, with diffuse proliferation, sometimes necrosis, usually nephritic syndrome
- Diffuse membranous nephritis (V): deposits, usually nephrotic syndrome

 

[osli]

Ah... didn't read to the bottom of the thread... pretty much what ^^^ said above.

 

[gildas]

I believe that it can be

1.) mesangial (in type II), so it resembles diabetic nephropathy in this respect.

2.) subendothelial (in type III, IV), since it's immune complexes.

3.) subepithelial (in type V) since this manifestation is more like membranous glomerulonephritis.

For test purposes, it would usually be subendothelial, particularly since type IV is the most severe and clinically critical.

Pretty much

 

[angrygunner]

does both

Nephritic type is subendothelial
Nephrotic type is subepithelial

Nephritic type is more common.

ha! could already see this as a nice UWorld punk question

yup, SLE is normally in neprhitic syndrome (as part of type 2 RPGN).
However, if you have a pt with SLE that presents with neprhOtic syndrome, then its membranous nephropathy which has subEPIthelial deposits.