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Crescentic glomerulonephritis: a clinical and histomorphological analysis of 46 cases

Ruchika Gupta1, Lavleen Singh, Alok Sharma

  • 1Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

Indian Journal of Pathology & Microbiology
|September 22, 2011
PubMed

Insights

Crescentic glomerulonephritis (CrGN) is a major cause of acute kidney injury. Accurate classification via immunohistology is crucial for effective treatment, especially in rare associated conditions.

Area of Science:

  • Nephrology
  • Pathology
  • Internal Medicine

Background:

  • Crescentic glomerulonephritis (CrGN) is characterized by crescents in over 50% of glomeruli.
  • It encompasses pauci-immune, immune complex-mediated, and anti-GBM disease categories.

Purpose of the Study:

  • To evaluate clinical, biochemical, and histological parameters in CrGN.
  • To correlate these parameters with disease categories and patient outcomes.

Main Methods:

  • Retrospective analysis of 46 renal biopsies diagnosed with CrGN (Jan 2008-Feb 2010).
  • Collection of clinical, laboratory, therapeutic, and outcome data.
  • Histological evaluation of glomerular, tubulo-interstitial, and arteriolar features.

Main Results:

  • Majority of cases (71.7%) were pauci-immune (PI), 28.3% immune complex-mediated (IC).
  • Gender ratio differed significantly between PI and IC groups (P=0.006).
  • Adults and presence of arteriolar fibrinoid necrosis were associated with poorer outcomes (P=0.05).
  • Four unusual associations noted: MPGN, leprosy, leukemia, C1q nephropathy.

Conclusions:

  • CrGN is a significant cause of acute renal failure requiring histological diagnosis.
  • Immunohistologic classification is essential for accurate diagnosis and treatment.
  • Consider CrGN in rare associations like leprosy or MPGN for timely intervention.
Abstract

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