SLE nephropathy

Discussion in 'Step I' started by Anaphylactic, May 7, 2008.

  1. Anaphylactic

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    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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  3. InternationlDoc

    InternationlDoc Imported like a Ferrari

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    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
     
  4. SeventhSon

    SeventhSon SIMMER DOWN

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

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

    mercaptovizadeh ἀλώπηξ

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    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.
     
  7. osli

    osli Senior Member

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    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
     
  8. osli

    osli Senior Member

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

    gildas Senior Member

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    Pretty much
     
  10. angrygunner

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    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.
     

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