8/25 Morning Report w/ Flang: Low complement nephrotic syndromes

A middle aged man w/ IVDU, HCV presented with worsening recurrent edema, found to have nephrotic syndrome.
Mnemonic for remembering low-complement glomerular disease: “C-LESS”
Cryoglobulins (+other types of MPGN which is the histologic dx for cryo)
Staph and Strep infections
Shunt nephritis (I had never heard of it, https://en.wikipedia.org/wiki/Shunt_nephritis )
Treatment of HCV-mediated cryoglobulinemia:
-All patients should be treated with antivirals for HCV
-There are specific indications for the addition of immunosuppression, including rapidly rising creatinine AND nephrotic range proteinuria (rituximab is usually first line though prednisone can also be used)

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