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Different causes of different nephritis2017-03-16 10:51
Acute interstitial nephritis
(1) drug-induced acute interstitial nephritis
The drug is the major cause of acute interstitial nephritis, acute interstitial nephritis accounted for more than half of them, within the most common is antibiotics, including penicillin and cephalosporins, and methicillin. Other drugs includ non steroidal anti-inflammatory drugs, diuretics, rifampicin, some antitumor drugs and contrast agents and so on. Recently, proton pump inhibitor induced acute interstitial nephritis caused more concern, especially with omeprazole and lansoprazole are common. In addition, it has made progress on the search of causing renal damage by Aristolochia manshuriensis Kom and Aristolochia fangchi, which contain Aristolochhia acid, and other Chinese herbals
Acute interstitial nephritis causing by systemic or renal infection include Streptococcus infection, mycoplasma pneumonia, leptospirosis, infectious mononucleosis induced disease, cytomegalovirus infection, Legionella infection, diphtheria infection and other infectious diseases. The study of human immunodeficiency virus acquired immunodeficiency syndrome (HIV) associated nephropathy has made a breakthrough, and it has been proved that the HIV-1 infection of epithelial cells plays an important role in the glomerular lesions of the associated nephropathy.
(3) tubulointerstitial nephritis
Uveal inflammation also known as idiopathic interstitial nephritis, the etiology and pathogenesis is not clear. Glucocorticoid treatment is effective and the prognosis is good. Other diseases like autoimmune systemic lupus erythematosus, Sj gren's syndrome, cold globulin, Wegener's granulomatosis, sarcoidosis, etc, can cause acute interstitial nephritis. More are the signs of disease activity. Uric acid nephropathy, gouty nephropathy, high calcium nephropathy, low potassium nephropathy and other metabolic diseases can cause acute interstitial nephritis.
Induced lupus nephritis
(1) genetic factors: genetic factors play a key role in the pathogenesis of lupus nephritis. Patients with lupus nephritis may have a family history, and the prevalence of the disease is high.
(2) sex hormones: in clinical, the disease was significantly more in women than men, and more in the fertility, it is believed that estrogen are realated to the occurrence of the disease. Pregnancy can worsen the disease.
(3) psychological factors: psychological stress can not only promote the activity of lupus nephritis, but also may be the cause of lupus nephritis. However, the intensity of stress response to individual is affected by the consitution, personality traits and stressful life events intensity, duration and frequency.
(4) environmental factors: viral infection and exposure to sunlight or ultraviolet light, there are 40% lupus nephritis patients are sun allergy. In addition, cold or strong electric light irradiation can induce or aggravate the disease.
(5) certain drugs and foods: changes in certain drugs and foods may also be related to the development of lupus nephritis.
The etiology of acute glomerulonephritis
(1) acute streptococcal infection nephritis: this kind of acute nephritis is the most common in clinic. There are many species of Streptococcus, each with different subtypes. Streptococcus can cause acute nephritis, include β-hemolytic streptococcus group a type of 1, 2, 3, 4, 18, 25, 49, 55, 57, 60, but the ratio of the occurrence of nephritis are not constant, while type twelfth is the cause of most acute nephritis. Therefore, acute glomerulonephritis caused by Streptococcus infection, more are beta hemolytic streptococcus a group (group A) type twelfth. The clinical evidence of streptococcal infection can be found, such as the lesions can develop in epidemic pathogens, streptococcus infection, such as fever epidemic, the incidence rate is high, the serum antistreptolysin "O "titer is high, streptococcal antigens can be found in glomerular etc..
(2) after the infection of Streptococcus pneumoniae: this kind of acute glomerulonephritis is caused by activation of the complement system. The incubation period is short, and the clinical manifestations are similar to those of Streptococcus infection, except for sodium and water retention.
(3) after the infection of Staphylococcus aureus:this kind of acute glomerulonephritis is caused by activation of the complement system or immune complexes. Much as diffuse hyperplastic entity. In clinic, the incidence of acute nephritis caused by this kind of infection is relatively high.
(4) after virus infection nephritis: influenza virus, measles virus, varicella virus, mumps virus, adenovirus infection, despite the onset of acute glomerulonephritis rate is very low, its mechanism is not clear, but if there is a history of viral infection and bacterial infection in clinical symptoms, change of urine light, comprehensive nephritis atypical syndrome, should consider whether it is