Role of pathogens in glomerulonephritis · Precipitin reaction Ag/Ab ˂1 =1 ˃1. Bari 12.11.2017....
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Il cane leishmaniotico nefropatico: quando non effettuare terapia leishmanicida Andrea Zatelli DMV Medical Consultancy Services – Malta [email protected]Bari 12 Novembre 2017 Bari 12.11.2017
Role of pathogens in glomerulonephritis · Precipitin reaction Ag/Ab ˂1 =1 ˃1. Bari 12.11.2017. The amount of precipitate that is recovered when an increasing amount of Ag is added
The location of the IC deposition determines the histologic changes abserved and the severity of glomerular disfunction and degree of proteinuria
Therapy? Bari 12.11.2017
IC in the glomerulus
1. Ag-Ab equivalence - Soluble circulating IC are
trapped in the glomerulus
2. Ab excess – IC tends to be large and insoluble
and are removed by phagocytic cells
3. Ag excess – IC do not readily bind complement
and are less likely to produce immunological
injury
Bari 12.11.2017
Relatore
Note di presentazione
In course of a type III reaction, the complexes formed between a monoclonal Ab and its Ag or the complex formed between a polyclonal Ab and a hapten are soluble. However the complexes between polyclonal Ab or myxtures of monoclonal Ab and a large Ag often lead to the formation of an insoluble precipitate (the so-called precipitin reaction)
Precipitin reaction Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
Precipitin reaction
.
.
Dep
ositi
on
Phag
ocyt
osis
No
inju
ry
Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
Precipitin reaction
Ag/Ab
˃1 =1 ˂1
Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
Therapy (leishmanicidal)
Increased Ag concentration
Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
Therapy (leishmanicidal)
Increased Ag concentration
Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
Therapy (leishmanicidal)
Increased Ag concentration
Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
Therapy (leishmanicidal)
Increased Ag concentration
Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
Case #1 - MAX
•Mixed breed, 7 yrs old, castrated male
•Indoor and outdoor, Malta
•Depressed, BCS 2/5
Bari 12.11.2017
Case #1 - MAX Bari 12.11.2017
Case #1 - MAX Bari 12.11.2017
IFA Leishmania 1:640
Case #1 - MAX Bari 12.11.2017
Case #1 - MAX
•Depressed, BCS 2/5
•Hypoalbuminemia, Hyperglobulinemia
•Increased creatinine
•Anemia
•Thrombocytopenia
•Serology + parasite
Bari 12.11.2017
Therapy? Bari 12.11.2017
1 2 3
5 25 30
CHECK CHECK
Creatinine 1,9 mg/dl Day 0
? Case #1 - MAX Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
1 2 3
5 25 30
CHECK CHECK
Creatinine 1,9 mg/dl
Creatinine 2,7 mg/dl
Day 0
Case #1 - MAX Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
1 2 3
5 25 30
CHECK CHECK
Creatinine 1,9 mg/dl
Creatinine 2,7 mg/dl
Creatinine 1,6 mg/dl
Day 0
Case #1 - MAX Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
1 2 3
5 25 30
CHECK CHECK
Creatinine 2,6 mg/dl Day 0
Case #2 Toby
? Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
1 2 3
5 25 30
CHECK CHECK
Creatinine 2,6 mg/dl
Creatinine 2,2 mg/dl
Day 0
Case #2 Toby Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
1 2 3
5 25 30
CHECK CHECK
Creatinine 2,6 mg/dl
Creatinine 2,2 mg/dl
Creatinine 1,8 mg/dl
Day 0
Case #2 Toby Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
1 2 3
5 25 30
CHECK CHECK
Creatinine 1.4 mg/dl Day 0
Case #3 Jack ? Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
1 2 3
5 25 30
CHECK CHECK
Creatinine 1.5 mg/dl Day 0
Case #3 Jack
Creatinine 2,9 mg/dl
8
CHECK
Creatinine 3,8 mg/dl
Bari 12.11.2017
Relatore
Note di presentazione
The amount of precipitate that is recovered when an increasing amount of Ag is added to a constant amount of Ab follow a typical pattern. The amount of Ab precipitated increases with the amount of Ag (zone 1) up to a maximum (zone 2), after which further increase in the amount of Ag leads to a decrease in the amount af Ab precipitated (zone3)
Helpful tips
1. Seroconversion (TEST)
2. Ic & clinical manifestation
3. Precipitin reaction (Ag/Ab)
4. AKI Vs CKD Vs AKI on CKD?
5. Nephrotoxicity?
Bari 12.11.2017
Relatore
Note di presentazione
In course of a type III reaction, the complexes formed between a monoclonal Ab and its Ag or the complex formed between a polyclonal Ab and a hapten are soluble. However the complexes between polyclonal Ab or myxtures of monoclonal Ab and a large Ag often lead to the formation of an insoluble precipitate (the so-called precipitin reaction)
Il cane leishmaniotico nefropatico:
quando non effettuare terapia leishmanicida?
Bari 12.11.2017
Relatore
Note di presentazione
In course of a type III reaction, the complexes formed between a monoclonal Ab and its Ag or the complex formed between a polyclonal Ab and a hapten are soluble. However the complexes between polyclonal Ab or myxtures of monoclonal Ab and a large Ag often lead to the formation of an insoluble precipitate (the so-called precipitin reaction)
