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Differential diagnosis of nephrotic syndrome

2017-03-01 11:43

1 Henoch Schonlein purpura nephritis

Predilection for young people, there are typical skin purpura, often symmetrical distribution in the distal limbs, more than 1 to 4 weeks after the rash appears hematuria and / or proteinuria.

2 systemic lupus nephritis

Good hair in middle-aged women and young people, immunological examination of a variety of autoantibodies, as well as multi system damage, can be diagnosed.

3 hepatitis B virus associated glomerulonephritis

More common in children and adolescents, the main clinical manifestations of proteinuria or NS, the common pathological type of membranous nephropathy. Diagnostic criteria: serum HBV antigen positive; glomerular nephritis, and exclude secondary glomerulonephritis; renal biopsy slice to find HBV antigen.

4 diabetic nephropathy

Good hair in the elderly, common in the course of more than 10 years of diabetes patients. Early detection of urinary albumin excretion increased, and gradually developed into a large number of proteinuria, NS. The history of diabetes mellitus and the characteristic changes of fundus are helpful in differential diagnosis.

5 renal amyloidosis

In the middle and old age, renal amyloidosis is a part of multiple organ involvement. Mainly involving the heart, primary amyloidosis kidney and digestive tract (including the tongue), skin and nerve; secondary amyloidosis often secondary to chronic suppurative infection, tuberculosis, cancer and other diseases, mainly involving kidney, liver and spleen. Renal involvement increased volume, often NS. Renal amyloidosis is often diagnosed by renal biopsy.

6 myeloma nephropathy

Good hair in the elderly, male, patients may have characteristics of multiple myeloma clinical manifestations, such as pain, serum monoclonal globulin increased, protein electrophoresis band M and urine protein positive this week, showed bone marrow plasma cells (more than 15% nucleated cells), and accompanied by quality change. NS may occur in multiple myeloma with renal involvement. The characteristics of the myeloma are helpful for differential diagnosis.

 

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