Kidney nontumor
Primary glomerular diseases
Rapidly progressive (crescentic) glomerulonephritis

Author: Nikhil Sangle, M.D. (see Authors page)

Revised: 31 October 2017, last major update February 2014

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PubMed Search: Rapidly progressive [title] crescentic glomerulonephritis

Related topics: TYPE 1, TYPE 2, TYPE 3
Cite this page: Sangle, N. Rapidly progressive (crescentic) glomerulonephritis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/kidneyrpgn.html. Accessed November 20th, 2017.
Definition / general
  • 3 subtypes based on immunofluorescence and EM (see Related topics above)
  • Rapid, usually irreversible, loss of renal function (usually 50% decline in glomerular filtration rate within 3 months), with glomerular crescent formation in 50 - 75% of biopsied glomeruli (eMedicine: Rapidly Progressive Glomerulonephritis)
  • Also called extracapillary proliferative glomerulonephritis, because cell proliferation is primarily in Bowman's space
Etiology
  • Due to deposition of fibrin, epithelial cells and inflammatory cells; may have various causes
Clinical features
  • Symptoms of nephritic syndrome, nephrotic syndrome and renal failure
  • Unresponsive to steroids
  • Causes death within weeks if untreated
  • Prominent feature is crescents, the end result of damage to glomerular basement membrane or Bowman's capsule
  • Crescents affect 50% of glomerular circumference, 70% of glomeruli
Case reports
Microscopic (histologic) description
  • Crescents in glomeruli are proliferation of parietal epithelium of Bowman’s capsule with macrophages, neutrophils, lymphocytes, fibrin and collagen
  • Also see glomerular capillary collapse, atrophic tubules and interstitial inflammation
Microscopic (histologic) images

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Cellular crescents (PAS)


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Cellular crescent

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Crescent with necrotizing area on Trichrome

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Fibrinogen in crescent IF

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Linear IgG in Goodpasture's syndrome



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Various images (H&E and PAS)


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PAS-Silver stain and immunofluorescence

Electron microscopy images
  • Wrinkling and focal disruptions in glomerular basement membrane
Differential diagnosis