Rapidly progressive glomerulonephritis with antibodies against glomerular basement membranes in serum and kidneys

Four cases of rapidly progressive glomerulonephritis with similar clinical courses are presented. Examination of kidney biopsies from these patients showed severe glomerulitis with capillary necrosis, fibrin thrombi and interstitial inflammation but no vasculitis. Electron microscopy showed wrinkled capillary basement membranes which were irregularly thickened, homogenous and had an irregular fibrillar structure. No localized deposits were observed. Immunohistological examination demonstrated linear and diffuse deposition of IgG and C3 along glomerular basement membranes. Nephrectomized kidneys from these patients were eluted and shown to contain antibodies against glomerular basement membrane. These antibodies were also present in sera of three of the patients.