Differential Diagnosis for Glomerular Disease
Single Most Likely Diagnosis
- IgA Nephropathy: This is often considered the most common cause of glomerular disease worldwide, characterized by the deposition of IgA antibodies in the glomeruli. It typically presents with recurrent episodes of hematuria, especially following upper respiratory infections.
Other Likely Diagnoses
- Minimal Change Disease: A common cause of nephrotic syndrome, especially in children, characterized by the loss of foot processes of podocytes as seen on electron microscopy, but with minimal changes on light microscopy.
- Focal Segmental Glomerulosclerosis (FSGS): A leading cause of nephrotic syndrome in adults, characterized by sclerosis (scarring) of some glomeruli, which can be primary (idiopathic) or secondary to other conditions.
- Membranous Nephropathy: An immune-mediated disease characterized by the formation of immune complexes on the subepithelial side of the glomerular basement membrane, often presenting with nephrotic syndrome.
Do Not Miss Diagnoses
- Goodpasture Syndrome: An autoimmune disease caused by antibodies against the glomerular basement membrane, which can lead to rapidly progressive glomerulonephritis and pulmonary hemorrhage if not promptly treated.
- ANCA-Associated Vasculitis: Conditions such as Granulomatosis with Polyangiitis (GPA), Microscopic Polyangiitis (MPA), and Eosinophilic Granulomatosis with Polyangiitis (EGPA) can cause rapidly progressive glomerulonephritis and require early recognition and treatment to prevent organ damage.
- Lupus Nephritis: A complication of Systemic Lupus Erythematosus (SLE), which can cause various types of glomerular injury, including proliferative and membranous changes, and is a significant cause of morbidity in SLE patients.
Rare Diagnoses
- Alport Syndrome: A genetic disorder characterized by glomerulonephritis, end-stage kidney disease, and hearing loss, due to mutations in the genes that code for type IV collagen.
- Thin Basement Membrane Nephropathy: A benign condition characterized by a uniformly thin glomerular basement membrane, often presenting with isolated hematuria.
- Membranoproliferative Glomerulonephritis (MPGN): A pattern of glomerular injury characterized by thickening of the glomerular basement membrane and proliferation of glomerular cells, which can be caused by various factors including infections, autoimmune diseases, and monoclonal gammopathy.