Nephritic syndrome - Causes and Symptoms

Definition

Nephritic syndrome is a symptom of glomerular inflammation (glomerulonephritis).

The triggering causes vary according to age, as well as the mechanisms that determine its onset.

On microscopic examination of the urinary sediment, the nephritic syndrome is defined by the presence of hematuria, erythrocyte cylinders and dysmorphic red blood cells. Frequently reported signs also include mild to moderate proteinuria, edema, hypertension, elevated serum creatinine and oliguria.

The nephritic syndrome can be primary (idiopathic) or secondary. Primary forms include IgA nephropathy and fibrillar glomerulonephritis.

Secondary nephritic syndrome, on the other hand, can manifest itself in case of infections (and post-infective outcomes):

Bacterial: group A streptococcus β-haemolytic infections, staphylococcus, mycoplasmas, Streptococcus pneumoniae, Neisseria meningitidis and Salmonella typhi;
Viral: Cytomegalovirus infections, Coxsackievirus, hepatitis B, hepatitis C, measles, mumps and varicella, Epstein-Barr virus;
Parasitic: malaria, schistosomiasis and toxoplasmosis.

Furthermore, Candida albicans and rickettsial infections can cause nephritic syndrome.

Glomerulonephritis can also be caused by other nephropathies and systemic diseases, such as connective tissue disorders (eg Wegener's granulomatosis and systemic lupus erythematosus) and some hematologic dyscrasias (eg haemolytic-uremic syndrome).