MPO-ANCA associated crescentic glomerulonephritis with numerous immune complexes: case report
Related Experiment Video
Updated: May 21, 2026

Supervised Machine Learning for Semi-Quantification of Extracellular DNA in Glomerulonephritis
Published on: June 18, 2020
Ryuji Morizane1, Konosuke Konishi, Akinori Hashiguchi
1Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. morizanr@da2.so-net.ne.jp
Background:
Antineutrophil cytoplasmic antibody (ANCA)-associated crescentic glomerulonephritis (CGN) is a major cause of rapidly progressive glomerulonephritis (RPGN). ANCA-associated CGN is generally classified into pauci-immune RPGN, in which there are few or no immune complexes.
Case Presentation:
A 78-year-old man presented with RPGN after a 7-year course of chronic proteinuria and hematuria with stable renal function. A blood examination showed a high titer of myeloperoxidase (MPO)-ANCA. A renal biopsy showed crescentic glomerulonephritis with abundant subepithelial, intramenbranous and subendothelial deposits by electron microscopy, leading to the diagnosis of ANCA-associated CGN superimposed on type 3 membranoproliferative glomerulonephritis (MPGN).
Conclusions:
This case is unique in that type 3 MPGN and MPO-ANCA-associated CGN coexisted, and no similar case has been reported to date. Because ANCA-associated CGN has a predilection for elderly individuals and primary type 3 MPGN is rarely seen in this age group, coincidental existence appears less likely. This case may confer valuable information regarding the link between immune complex and ANCA-associated CGN.
Related Concept Videos
Nephrotic Syndrome I : Introduction
Acute Pyelonephritis II: Diagnostic Studies and Management
Nephrotic Syndrome II : Assessment and Medical Management
Acute Pyelonephritis I: Introduction
Nephrotic Syndrome III : Nursing Management