. functional and clinical similarities exist witn in the group because of the limited ways a tissue can respond to injury, and-these injuries manifest as symptoms and signs Mechanism of glomerular injury - Many glomerular diseases, whether occurring in isolation or as part of multisystem dseases are assocteted with demonstrable irmmunological abnormalities. There are two possible mechanisms. 1. Antigen in kiotiey - (in situ complex formation) - Antigen may be an intrinsic part of the Glomerulus, or derived Irom other parts of the body and deposited in the glomerulus. Thus formation ol antigen-antibody complex can occur it an appropriate antibody is generated 2 Antigen remote from the kidney - (Antigen either endogenous or exogenous from other sources than the kidney) - When the antigen-antibody complex gains access to, or Is produced in the circulation. It can be deposited in the kidneys, where it activates medialors of Inflammation. The production of glomerular Injury is complex and probably depends on linked cellular and non-cellular mechanisms. Immunoistipathological study of renal tissue from renal biopsies reveals antibody (IgG, IgM or IgA) and complement components. Also the common findng of monocyies, macrophages (producers of TNF-alpha and interleukln-1) and T helper lymphocytes (producers ol lnterleukin-2) suggests a rale lor these cells andcytaklnes In paihogenesis. CAUSES of glomerular disease 1 HEREDITARY DISORDERS - (a) Airport's syndrome - Progressive nephritis and sensorineural hearing loss. Characteristic "bask et-weave' appearance 0* glomerular base me nt membrane (b) Thin membrane basement disease - presents as recurrent hematurla (c) Familial clusters - Some conditions like minimal change nephropathy, focal and segmental glomerulosclerosis have been reported in familial clusters. 2. SECONDARY AND SYSTEMIC DISORDERS -
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