Thin basement membrane disease history and symptoms: Difference between revisions

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==Overview==
==Overview==


==History and symptoms==
==Biopsy==
Most patients with thin basement membrane disease are incidentally discovered to have [[microscopic hematuria]] on [[urinalysis]]. The [[blood pressure]], [[kidney function]], and the urinary protein excretion are usually normal. Mild [[proteinuria]] (less than 1.5 g/day) and [[hypertension]] are seen in a small minority of patients. Frank [[hematuria]] and loin pain should prompt a search for another cause, such as  [[kidney stone]]s or [[loin pain-hematuria syndrome]]. Also, there are no systemic manifestations, so presence of [[hearing impairment]] or [[visual impairment]] should prompt a search for [[hereditary]] nephritis such as [[Alport syndrome]].
A [[needle aspiration biopsy|kidney biopsy]] is the only way to diagnose thin basement membrane disease. It reveals thinning of the [[glomerular basement membrane]] from the normal 300 to 400 nanometers (nm) to 150 to 250 nm. However, a [[needle aspiration biopsy|biopsy]] is rarely done in cases where the patient has isolated [[microscopic hematuria]], normal [[kidney function]], and no [[proteinuria]]. The prognosis is excellent in this setting unless the clinical manifestations progress, as occurs in most males and some females with [[Alport syndrome]] and many patients with [[IgA nephropathy]].
 
Thin basement membrane disease must be differentiated from the other two common causes of [[glomerulus|glomerular]] [[hematuria]], [[IgA nephropathy]] and [[Alport syndrome]]. The history and presentation are helpful in this regard:
*In [[Alport syndrome]], there is often a family history of [[kidney failure]], which may be associated with [[hearing impairment]]. Also, males tend to be more affected as Alport syndrome it is [[X-linked]] in most cases.
*In [[IgA nephropathy]], episodes of frank [[hematuria]] are more common, and a family history is less common.


==References==
==References==

Revision as of 18:31, 28 September 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Biopsy

A kidney biopsy is the only way to diagnose thin basement membrane disease. It reveals thinning of the glomerular basement membrane from the normal 300 to 400 nanometers (nm) to 150 to 250 nm. However, a biopsy is rarely done in cases where the patient has isolated microscopic hematuria, normal kidney function, and no proteinuria. The prognosis is excellent in this setting unless the clinical manifestations progress, as occurs in most males and some females with Alport syndrome and many patients with IgA nephropathy.

References

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