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Rapid progressive glomerulonephritis: relapse after prolonged remission

S Adler, F J Bruns, D S Fraley

    Archives of Internal Medicine
    |June 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

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    Rapid progressive glomerulonephritis (RPGN) can recur even after prolonged remission in all its forms. Prompt treatment of exacerbations can induce a second remission, preserving kidney function.

    Area of Science:

    • Nephrology
    • Immunology

    Background:

    • Rapid progressive glomerulonephritis (RPGN) is a severe kidney disease characterized by rapid loss of kidney function.
    • Epithelial cell crescents in renal biopsies indicate severe glomerular injury and are a hallmark of RPGN.

    Observation:

    • Three patients with RPGN and epithelial cell crescents achieved prolonged remission with oral prednisone, cyclophosphamide, and plasmapheresis.
    • After extended remission periods, all three patients experienced renal function deterioration and crescent recurrence upon repeat biopsy.

    Findings:

    • Recurrence of RPGN was observed across different etiological subtypes, including anti-GBM disease, immune complex disease, and immune deposit-negative RPGN.
    • Re-treatment with either triple therapy or high-dose intravenous steroids successfully induced a second remission in all patients.

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    Implications:

    • RPGN can relapse even after long-term remission, irrespective of its underlying cause.
    • Prompt intervention during exacerbations is crucial for achieving subsequent remissions and managing RPGN.