PATHOLOGY Renal N* Q-2

[Roxanita]

An afebrile 8-year-old girl is evaluated for mild edema and a "puffy" face. She recovered from an untreated sore throat and fever 3 weeks ago. Urinalysis shows moderate proteinuria and hematuria with occasional red cell casts. A photomicrograph of renal tissue obtained on biopsy is shown. Which of the following is most likely responsible for the cellular infiltrate shown?

http://ajoupath.ajou.ac.kr/slides/kidney/kd03a.jpg

A) Bradykinin

B) C5a

C) Histamine

D) N-formylated peptides

E) Serotonin

[Roxanita]

Acute Poststreptococcal Glomerulonephritis

Pathophysiology: Most forms of AGN are mediated by an immunologic process. For PSAGN, the evidence suggests that immune complexes, preformed by the combination of specific Antibodies against Streptococcal antigens, localize on the glomerular capillary wall and activate the complement system. The immunologic system may also be activated by streptococcal antigens that adhere to the glomerular structures and act as "planted antigens" or by alterations in endogenous antigens. The activation of the complement cascade then generates chemotactic plasma-activated complement 5 (C5a) and platelet-derived inflammatory mediators. Various cytokines and other cellular immunity factors initiate an inflammatory response manifested by cellular proliferation and edema of the glomerular tuft.

Ref: http://www.emedicine.com/ped/topic27.htm